chemotherapy implant
Biodegradable chemotherapy seeds with irinotecan deliver localized treatment for GBM, overcoming blood-brain barrier limitations and systemic side effects, enhancing treatment efficacy.
Patent Information
- Application Number
- JP2022536494
- Authority / Receiving Office
- JP · JP
- Patent Type
- Patents
- Current Assignee / Owner
- Priority Date
- 2019-12-12
- Filing Date
- 2020-12-11
- Publication Date
- 2026-01-16
- Estimated Expiration
- 2040-12-11
AI Technical Summary
Current treatments for glioblastoma multiforme (GBM) are limited by the blood-brain barrier, requiring high systemic drug levels that cause severe side effects, and existing local delivery methods have limited penetration and efficacy.
A biodegradable chemotherapy seed comprising irinotecan or its derivatives, embedded in a biodegradable polymer, designed for localized delivery to brain tumors, providing a sustained drug release profile of at least 3 days.
The chemotherapy seeds achieve effective drug delivery directly to the tumor site, reducing systemic side effects and maintaining therapeutic levels for an extended period, improving treatment outcomes for GBM.
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Abstract
Description
[Technical Field]
[0001] The present invention relates to chemotherapeutic implants, more particularly to biodegradable chemotherapeutic implants comprising irinotecan or a derivative or pharmaceutically acceptable salt thereof. The present invention also relates to methods for making these chemotherapeutic implants and their use in therapy, particularly in the treatment of brain tumors. [Background technology]
[0002] The most common malignant primary brain tumor in adults is glioblastoma multiforme (GBM) [1]. GBM accounts for 45.2% of primary malignant brain and CNS tumors, gliomas [2], with an annual incidence of 3.19 per 100,000 people worldwide [3]. It is invasive and one of the most aggressive tumors of the central nervous system, characterized histologically by high cellularity, nuclear atypia, microvascular proliferation, brisk mitotic activity, and necrosis. Upon initial diagnosis of GBM, the standard treatment, known as the Stupp protocol [4], involves surgical resection with maximal tumor-free margins ("debulking"), radiation therapy combined with temozolomide chemotherapy, and additional high-dose temozolomide chemotherapy after each radiation therapy cycle. Even with complete surgical resection of the tumor combined with this highly aggressive treatment, patients have an overall survival of only 12–15 months, with a 5-year survival rate of 5% [5].
[0003] GBM is a highly invasive brain tumor that cannot be completely removed surgically, making tumor recurrence almost inevitable, with 80–90% recurrence occurring within 2 cm of the resection site.[6] There are no established chemotherapy regimens available for patients who relapse, and an increasing number of patients with recurrent GBM undergo reoperation to control their disease after traditional second-line treatments have failed.
[0004] Most GBM treatments fail because they are administered either intravenously or orally. Systemic delivery of chemotherapy drugs to the brain is limited by the blood-brain barrier (BBB), and high systemic drug levels are required to achieve the necessary therapeutic levels in the brain. Localized delivery directly to the resection margin at the time of surgery using an implantable device allows chemotherapy drugs to be delivered directly to the brain, offering many advantages, including lower doses by avoiding systemic circulation, improved patient tolerance, and fewer side effects.
[0005] The Gliadel® wafer is a local delivery device approved by the Food and Drug Administration in 1996 for the treatment of recurrent GBM. It is a disc-shaped, 200 mg biodegradable wafer containing 3.85% w / w of the chemotherapy drug carmustine. Gliadel® has shown a small but significant benefit in combination with surgery in patients with recurrent glioma.[7] However, Gliadel® and other similar approaches rely on drug diffusion from the device into the brain parenchyma and are limited by a penetration distance of a few millimeters.
[0006] Biodegradable implants are used for local drug delivery because they are relatively easy to administer and can be designed to control the release of a wide range of therapeutic agents. For example, Ramachandran et al. described the delivery of temozolomide from a theranostic nanobrain implant for the long-term, localized treatment of recurrent gliomas. [8] McConville et al. described the development of disulfiram-loaded poly(lactic-co-glycolic acid) (PLGA) millirods for the treatment of GBM administered via stereotactic injection into the tumor. [9] Lesniak et al. demonstrated the efficacy of doxorubicin-loaded biodegradable wafers using a GBM rat model.
[10] Zembeko et al. described the fabrication of disulfiram-loaded PLGA wafers for the localized treatment of GBM.
[11]
[0007] Irinotecan (IRN) is a semisynthetic prodrug whose active metabolite, 7-ethyl-10-hydroxycamptothecin, also known as SN-38, acts as an inhibitor of the topoisomerase I group of enzymes. Topoisomerase I enzymes act within cells to induce transient breaks in one or both strands of DNA, allowing the DNA to unwind for transcription and replication. During this process, topoisomerase I forms covalent bonds with DNA, allowing it to form a cleavable complex. SN-38 binds to topoisomerase I in this configuration, preventing the enzyme from rejoining the DNA strands and causing S-phase-specific cell death
[12] .
[0008] Currently, IRN is part of the standard treatment regimen for advanced colorectal cancer when used in combination with 5-fluorouracil (5-FU) and folinic acid. In the treatment of GBM, IRN administered as intravenous monotherapy has a response rate of 0–44%, with progression-free survival ranging from 2–11 months; IRN in combination with other drugs has a response rate of 13–100%, with progression-free survival ranging from 3–12 months
[13] .
[0009] IRN crosses the BBB, but therapeutic levels in the brain require 125–500 mg / m 2 High intravenous doses of IRN are required, resulting in serious systemic side effects, including gastrointestinal toxicity leading to early- and late-onset diarrhea and severe neutropenia. The problems of severe diarrhea and neutropenia, as well as the need to increase IRN levels in the brain, have spurred recent developments to improve IRN's ability to cross the BBB.
[0010] Direct local delivery of IRNs to the brain tumor resection site may improve treatment outcomes by allowing for the delivery of higher doses directly to the tumor site while reducing systemic concentrations and therefore the aforementioned side effects.
[0011] Baltes et al. demonstrated a significant difference in survival in GBM rats treated with 100-300 μm drug-eluting beads containing IRN compared with a placebo group
[14] . Furthermore, there was no local toxicity or significant bleeding associated with the IRN bead implantation area. In vitro IRN elution from the drug-eluting beads was rapid.
[0012] A phase I clinical trial demonstrated that IRN drug-eluting beads are safe for local treatment of tumor margins in patients with GBM, and preliminary survival data were comparable to Gliadel® when compared with historical controls.
[15] However, pharmacokinetic data showed that the majority of IRN was cleared from the brain within 48 hours, and all of it by 72 hours.
[0013] There remains an unmet need to provide a drug delivery system for the treatment of brain tumors that is effective against even the most aggressive tumors while avoiding the undesirable side effects associated with current treatments.
[0014] The present invention was conceived with the above in mind. Summary of the Invention
[0015] In a first aspect, the present invention provides a chemotherapy seed comprising a biodegradable polymer and a drug selected from IRN, a pharmaceutically acceptable salt of IRN, a derivative of IRN, and a pharmaceutically acceptable salt of a derivative of IRN; the seed having a first length of at least 0.5 mm.
[0016] In another aspect, the present invention provides a chemotherapy seed comprising a biodegradable polymer and a drug selected from IRN, a pharmaceutically acceptable salt of IRN, a derivative of IRN, and a pharmaceutically acceptable salt of a derivative of IRN; the seed having a first length of at least 0.5 mm.
[0017] In a further aspect, the present invention provides a seed as described herein for use in therapy.
[0018] In a further aspect, the present invention provides a seed as described herein for use in the treatment of brain tumors, such as high-grade gliomas (e.g., GBM).
[0019] In another aspect, the present invention provides a pharmaceutical composition comprising one or more seeds described herein.
[0020] In a further aspect, the present invention provides a method for producing a pharmaceutical composition comprising the steps of: a) feeding a drug and a biodegradable polymer into a hot melt extruder; b) extruding the mixture through an extruder; c) forming the extrudate of step b) into one or more seeds of required dimensions The present invention provides a method for producing the chemotherapy seeds described herein, comprising:
[0021] These and further aspects of the invention are described in further detail herein. [Brief explanation of the drawings]
[0022] Specific embodiments of the present invention are further described below with reference to the accompanying drawings: [Figure 1] FIG. 1 shows the effect of plasticizer type and loading on (A) the diameter consistency of blank seeds during production; and the swelling of blank seeds in water when produced using (B) Kolliphor® RH40; (C) Kolliphor® P188; and (D) Kolliphor® P237 as plasticizers. [Figure 2] FIG. 2 shows an image of a 2 mm diameter by 6 mm long seed prepared according to Example 1 and loaded with 30 wt % IRN HCL. [Figure 3] FIG. 3 shows the extracted IRN HCl content of 2 mm diameter by 3 mm length seeds loaded with 10, 20, 30, 40, and 50 wt % IRN HCl, determined according to the method of Example 5. [Figure 4]FIG. 4 shows the extracted IRN HCl content of 30 wt % drug-loaded seeds having dimensions of 2×2 mm, 2×3 mm, and 2×6 mm, determined according to the method of Example 5. [Figure 5] FIG. 5 shows the extracted IRN HCl content of 30 wt % drug-loaded 2×6 mm seeds prepared according to Example 3 using: (A) 10% plasticizer; screw speed of 100 RPM; mixing temperature of 150° C.; (B) 0% plasticizer; screw speed of 100 RPM; mixing temperature of 150° C.; (C) 0% plasticizer; screw speed of 90 RPM; mixing temperature of 150° C.; (D) 0% plasticizer; screw speed of 90 RPM; mixing temperature of 140° C.; and (E) 0% plasticizer; screw speed of 90 RPM; mixing temperature of 130° C. [Figure 6] Figure 6 shows Raman images of cross sections of 2 x 6 mm seeds loaded with 30 wt% drug, prepared according to Example 3 using: (A) 10% plasticizer; screw speed of 100 RPM; mixing temperature of 150°C; (B) 0% plasticizer; screw speed of 100 RPM; mixing temperature of 150°C; (C) 0% plasticizer; screw speed of 90 RPM; mixing temperature of 150°C; (D) 0% plasticizer; screw speed of 90 RPM; mixing temperature of 140°C; and (E) 0% plasticizer; screw speed of 90 RPM; mixing temperature of 130°C. IRN HCl is dark for mapping. [Figure 7] 7 shows the cytotoxicity towards primary GBM cells of solutions of IRN HCl extracted from 2×3 mm seeds containing various loadings of IRN HCl compared to freshly prepared solutions of untreated IRN HCl at the same concentrations, as determined according to Example 8. [Figure 8] FIG. 8 shows the cytotoxicity towards primary GBM cells of solutions of IRN HCl extracted from 30 wt % seeds of various lengths compared to freshly prepared solutions of untreated IRN HCl at the same concentration, as determined according to Example 8. [Figure 9]FIG. 9 shows the cumulative in vitro elution of IRN HCl from 2 × 3 mm seeds containing various loading amounts of IRN HCl after 1 to 7 days of incubation under (A) sink conditions and (B) biorelevant conditions, as described in Example 9. [Figure 10] FIG. 10 shows the cumulative in vitro elution of IRN HCl from 30 wt % seeds of various lengths after 1 to 7 days of incubation under (A) sink conditions and (B) biorelevant conditions, as described in Example 9. [Figure 11] FIG. 11 shows the in vitro daily elution of IRN HCl over 7 days under biorelevant conditions from (A) 2×3 mm seeds containing various loadings of IRN HCl and (B) 30 wt % seeds of various lengths. [Figure 12] FIG. 12 shows the cumulative in vitro elution of IRN HCl from 30 wt % seeds made from PLGA of various intrinsic viscosities after incubation under sink conditions for 1 to 7 days. [Figure 13] FIG. 13 shows the cytotoxicity of IRN HCl eluted from 2×3 mm seeds containing various drug loads on days 1 and 7 towards primary GBM cells, as described in Example 10. [Figure 14] FIG. 14 shows the cytotoxicity of IRN HCl eluted from 30 wt % seeds of various lengths on days 1 and 7 on primary GBM cells, as described in Example 10. [Figure 15] FIG. 15 shows the cytotoxicity of IRN HCl on primary GBM cells eluted from 30 wt % seeds made from PLGA of various viscosities at days 1 and 7, as described in Example 10. [Figure 16] FIG. 16 shows the cytotoxicity of 2×3 mm seeds containing various loading amounts of IRN HCl on primary GBM cells harvested from the surgical margins of GBM patients at 1, 2, 3, 4, 5, and 7 days after incubation, as described in Example 11. [Figure 17]FIG. 17 shows histological sections of mouse brain (A) immediately after surgery (sham); (B) after treatment with drug-free placebo seeds, and (C), (D), and (E) after treatment with 30, 40, and 50 wt. % IRN HCl seeds, respectively, according to Example 12. [Figure 18] FIG. 18 shows toxicity scores for mouse brains treated with drug-free (0%) placebo seeds and 30, 40, and 50% by weight IRN HCl seeds over an 8-week period according to Example 12. [Figure 19] FIG. 19 shows images of the surgical site of a mouse according to Example 13 before incision, before resection (when the tumor was characterized), after resection, and with implanted IRN HCl seeds in place. [Figure 20] Figure 20 shows Kaplan-Meier survival plots for resected mice bearing the U87 human glioblastoma cell line immediately after surgery (sham), after treatment with drug-free (0%) placebo seeds; and after treatment with 30, 40, and 50 wt% IRN HCl seeds. [Figure 21] FIG. 21 shows images taken using a fluorescent microscope of selected surviving mice 70 days after implantation. [Figure 22] Figure 22 shows the in vitro cumulative release rate (A and B) and daily release (C and D) of irinotecan from seeds containing 10%, 30%, or 50% w / w IRN HCl loadings after 1 to 7 days of incubation under sink conditions when the seeds were manufactured using compression (A and C) or hot-melt extrusion (B and D). [Figure 23] Figure 23 shows cell viability of primary GBM cells harvested from eight patients with recurrent GBM after 5 days of exposure to increasing concentrations of irinotecan (IRN), temozolomide (TMZ), or irinotecan (IRN) plus pitavastatin (PVT). [Figure 24]FIG. 24 shows cell viability of primary GBM cells harvested from four recurrent GBM patients after 3, 5, 7, 9, and 11 days of exposure to 3.5 Log nM irinotecan, 5.0 Log nM temozolomide, or 2.5 Log nM irinotecan plus pitavastatin. [Figure 25] Figure 25 shows the daily in vitro release of drug from multilayered seeds containing (A) 30% IRN and 50% PVT in individual layers and (B) 40% IRN and 50% PVT in individual layers [dashed lines are the amounts of IRN and PVT that need to be released to be effective based on the data in Figures 23 and 24], as well as the cumulative in vitro release of drug from multilayered seeds containing (C) 30% IRN and 50% PVT in individual layers and (D) 40% IRN and 50% PVT in individual layers, after 1 to 14 days of incubation under sink conditions. [Figure 26] Figure 26 shows the cytotoxicity of (i) no drug (control); and (ii) multi-layered seeds containing 30% IRN and 50% PVT in individual layers; and (iii) 40% IRN and 50% PVT in individual layers when the seeds were placed directly on primary marginal cells taken from a recurrent GBM patient. DETAILED DESCRIPTION OF THE INVENTION
[0023] (chemotherapy seeds) As described above, the present invention provides a chemotherapy seed comprising a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; the seed having a first length of at least 0.5 mm.
[0024] By incorporating drugs into biodegradable seeds of the above dimensions, it is possible to achieve sustained drug release from the seeds for at least 3 days under physiological conditions, making the seeds of the present invention suitable for effective local drug delivery to the resection site of brain tumors, particularly GBM.
[0025] Irinotecan (IRN) has the following structure: [ka]
[0026] Derivatives of irinotecan include active metabolites of irinotecan, such as SN-38, which is the compound 7-ethyl-10-hydroxy-camptothecin, having the following structure: [ka] In one embodiment, the derivative of irinotecan is SN-38.
[0027] Pharmaceutically acceptable salts of the drugs of the present invention include acid addition salts of compounds of the present invention that are sufficiently basic, such as acid addition salts with inorganic or organic acids, such as hydrochloric acid, hydrobromic acid, sulfuric acid, phosphoric acid, trifluoroacetic acid, formic acid, citric acid, or maleic acid. Additionally, suitable pharmaceutically acceptable salts of drugs of the present invention that are sufficiently acidic are alkali metal salts, such as sodium or potassium salts, alkaline earth metal salts, such as calcium or magnesium salts, ammonium salts, or salts with organic bases that provide physiologically acceptable cations, such as salts with methylamine, dimethylamine, trimethylamine, piperidine, morpholine, or tris-(2-hydroxyethyl)amine.
[0028] In one embodiment, the drug is irinotecan. In one embodiment, the drug is a pharmaceutically acceptable salt of irinotecan, such as hydrochloride. In one embodiment, the drug is irinotecan hydrochloride. It is understood that the present invention also includes hydrates or solvates of the drugs of the present invention. In a specific embodiment, the drug is a hydrate of irinotecan hydrochloride. In a further embodiment, the drug is irinotecan hydrochloride trihydrate.
[0029] Suitable biodegradable polymers are those that can be decomposed under physiological conditions so that the polymer and its degradation products do not cause unacceptable toxicity or immune responses. Such polymers can be natural or synthetic in origin. Examples of natural biodegradable polymers include polysaccharides, such as chitosan, alginic acid, and dextran, or polyesters, such as polyhydroxyalkanoic acid. Examples of synthetic biodegradable polymers include polymers of lactic acid and glycolic acid, and copolymers thereof.
[0030] In one embodiment, the biodegradable polymer is a lactic acid-glycolic acid copolymer or polylactic acid, wherein each polymer is end-capped with an acid or ester group. In a preferred embodiment, the biodegradable polymer is a lactic acid-glycolic acid copolymer. A lactic acid-glycolic acid copolymer is also referred to herein as PLGA. In one embodiment, the biodegradable polymer is a PLGA end-capped with an acid group. In a preferred embodiment, the biodegradable polymer is a PLGA end-capped with an ester group.
[0031] The acidity of a biodegradable polymer can be quantified by determining its acid value by titration. This technique is well known in the art and typically involves dissolving a known amount of polymer sample in an organic solvent (e.g., isopropanol) and titrating it with a known concentration of potassium hydroxide solution using phenolphthalein as a color indicator. The acid value is expressed as mg of KOH required to neutralize 1 g of sample. In one embodiment, the biodegradable polymer has an acid value of 1 mg KOH / g or less. In one embodiment, the biodegradable polymer is PLGA, and the PLGA has an acid value of 1 mg KOH / g or less.
[0032] In one embodiment, the biodegradable polymer is PLGA, in which the lactic acid weight content of the PLGA is about 5-95%, with the remainder being glycolic acid. In one embodiment, the lactic acid weight content of the PLGA is about 10-90%, for example, about 20-80%, about 30-70%, or preferably about 40-60%, with the remainder being glycolic acid. In one embodiment, the PLGA has a lactic acid:glycolic acid weight ratio of about 5:95, about 15:85, about 25:75, about 40:60, about 50:50, about 60:40, about 75:25, about 85:15, or about 95:5. In a preferred embodiment, the PLGA has a lactic acid:glycolic acid weight ratio of about 40:60, about 50:50, or about 60:40. In a most preferred embodiment, the PLGA has a lactic acid:glycolic acid weight ratio of about 50:50. In a most preferred embodiment, the PLGA is end-capped with ester groups and has a weight ratio of lactic acid:glycolic acid of about 50:50. In a most preferred embodiment, the PLGA has a weight ratio of lactic acid:glycolic acid of about 50:50 and an acid value of 1 mg KOH / g or less.
[0033] In one embodiment, the biodegradable polymer is PLGA having a number average molecular weight of about 2-15 kDa, for example about 5-15 kDa or about 5-12 kDa.
[0034] In one embodiment, the PLGA has a weight ratio of lactic acid:glycolic acid of about 50:50 and a number average molecular weight of about 2-15 kDa. In one embodiment, the PLGA is end-capped with ester groups and has a weight ratio of lactic acid:glycolic acid of about 50:50 and a number average molecular weight of about 2-15 kDa. In a preferred embodiment, the PLGA has a weight ratio of lactic acid:glycolic acid of about 50:50, an acid value of 1 mg KOH / g or less, and a number average molecular weight of about 2-15 kDa.
[0035] In one embodiment, the PLGA has an intrinsic viscosity of 0.3 to 0.5 dL / g when measured in chloroform at a concentration of 0.5 g / dL at 25° C. In a preferred embodiment, the PLGA has an intrinsic viscosity of 0.2 to 1.2 dL / g, e.g., 0.25 to 1.2 dL / g, 0.3 to 1.0 dL / g, 0.3 to 0.8 dL / g, or 0.3 to 0.6 dL / g, when measured in chloroform at a concentration of 0.5 g / dL at 25° C. In a most preferred embodiment, the PLGA has an intrinsic viscosity of 0.3 to 0.5 dL / g when measured in chloroform at a concentration of 0.5 g / dL at 25° C.
[0036] In one embodiment, the PLGA has a weight ratio of lactic acid:glycolic acid of about 50:50, a number average molecular weight of about 2-15 kDa, and an intrinsic viscosity of 0.3-0.5 dL / g when measured in chloroform at a concentration of 0.5 g / dL at 25° C. In one embodiment, the PLGA has a weight ratio of lactic acid:glycolic acid of about 50:50, and an intrinsic viscosity of 0.3-0.5 dL / g when measured in chloroform at a concentration of 0.5 g / dL at 25° C. In one embodiment, the PLGA has a weight ratio of lactic acid:glycolic acid of about 50:50, an acid value of 1 mg KOH / g or less, and an intrinsic viscosity of 0.3-0.5 dL / g when measured in chloroform at a concentration of 0.5 g / dL at 25° C. In one embodiment, the PLGA has a weight ratio of lactic acid:glycolic acid of about 50:50, an acid value of less than or equal to 1 mg KOH / g, a number average molecular weight of about 2-15 kDa, and an intrinsic viscosity of 0.3-0.5 dL / g when measured at 25°C in chloroform at a concentration of 0.5 g / dL.
[0037] The drug loading in the chemotherapy seeds can be selected depending on the level of active substance required at the local delivery site and the required duration of drug coverage after implantation. In one embodiment, the drug is present at a loading of 1 to 50 weight percent (wt%) based on the weight of the seed. In one embodiment, the drug is present at a loading of 5 to 45 wt%, e.g., 5 to 45 wt%, 10 to 40 wt%, 30 to 45 wt%, 25 to 45 wt%, or 30 to 40 wt%, based on the weight of the seed. In one embodiment, the drug is present at a loading of 5 to 50 wt%, e.g., 10 to 50 wt%, 20 to 50 wt%, 25 to 50 wt%, or 30 to 50 wt%, based on the weight of the seed. In one embodiment, the drug is present at a loading of about 30 wt% or about 40 wt% based on the weight of the seed.
[0038] In one embodiment, the drug is irinotecan or a pharmaceutically acceptable salt of irinotecan, and the drug is present in a loading amount of 25-45% or 30-40% by weight based on the weight of the seed. In one embodiment, the drug is irinotecan or a pharmaceutically acceptable salt of irinotecan, and the drug is present in a loading amount of about 30% or about 40% by weight based on the weight of the seed.
[0039] In one embodiment, the drug is a pharmaceutically acceptable salt of irinotecan (preferably irinotecan hydrochloride) and is present in a loading amount of 25-45% or 30-40% by weight based on the weight of the seed. In one embodiment, the drug is a pharmaceutically acceptable salt of irinotecan (preferably irinotecan hydrochloride) and is present in a loading amount of about 30% or about 40% by weight based on the weight of the seed.
[0040] In one embodiment, the drug is a derivative of irinotecan (preferably SN-38) or a pharmaceutically acceptable salt of a derivative of irinotecan, and the drug is present at a loading amount of 1 to 20 wt%, 1 to 10 wt%, or 1 to 5 wt% based on the weight of the seed.
[0041] In one embodiment, the drug is selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, 7-ethyl-10-hydroxy-camptothecin (SN-38), and a pharmaceutically acceptable salt of SN-38.
[0042] The chemotherapy seeds according to the present invention can be in various shapes, such as spheres, plates, rods, cylinders, rectangular parallelepipeds or cubes. The seed manufacturing method can affect the shape of the seeds produced. For example, the shape and size of the seeds produced by extrusion can be controlled by selecting an extrusion die. Preferably, the seeds of the present invention are rod-shaped. As those skilled in the art will understand, a rod has the shape of a cylinder. In a preferred embodiment, the seeds are substantially cylindrical.
[0043] Seeds according to the present invention have a primary length of at least 0.5 mm. As used herein, the term "primary length" refers to the shortest dimension of the seed. For spherical seeds, this would be the diameter of the sphere, and for cubic seeds, this would be the length of the cube. For shapes with different length dimensions, such as a rectangular prism or cylinder, the primary length would be the shortest length and the secondary length would be the next shortest length (see schematic diagram below). [ka] Schematic of possible seed shapes (lr: sphere, cube, cuboid, cylinder) showing the first length (i) of each shape and the second length (ii) for cuboids and cylinders.
[0044] Thus, when the seed is substantially cylindrical, the first length is the diameter of the cylinder and the second length is the length of the cylinder. In one embodiment, the seed is substantially cylindrical, the first length is the seed diameter, and the second length is the seed length.
[0045] When the seed includes one or more pores or cavities, it is understood that the first length is defined with respect to the overall dimension of the seed.
[0046] The size of the seeds is important for delivering the desired drug profile. In one embodiment, the seeds have a first length of at least 1 mm, e.g., at least 1.5 mm. In one embodiment, the seeds have a first length of 0.5 to 5 mm, e.g., 0.5 to 4 mm, 1 to 4 mm, or preferably 1 to 3 mm. Seeds having a first length in the range of about 0.5 to 5 mm are particularly suitable for administration to a primary site via a catheter. In a preferred embodiment, the seeds have a first length of about 2 mm.
[0047] In one embodiment, the seeds have a second length of at least 1 mm, e.g., at least 1.5 mm. In one embodiment, the seeds have a second length of 1 to 10 mm, e.g., 1 to 8 mm, 1 to 7 mm, or preferably 2 to 6 mm. In preferred embodiments, the seeds have a second length of about 2 mm, about 3 mm, about 4 mm, about 5 mm, or about 6 mm.
[0048] In a preferred embodiment, the seeds have a first length of about 2 mm and a second length of about 3 mm or about 6 mm. In a preferred embodiment, the seeds are substantially cylindrical and have a first length of about 2 mm and a second length of about 3 mm or about 6 mm.
[0049] The seeds produced according to the present invention can be produced with or without plasticizer.In one embodiment, the seeds do not contain plasticizer.In order to be suitable for local implantation (for example, in brain parenchyma) in terms of minimizing the risk of adverse reactions, it is desirable that the seeds do not swell and have a smooth surface (characterized by the absence of so-called "shark skinning").Therefore, it may be necessary for the seeds to contain one or more plasticizers.In one embodiment, the seeds further comprise a pharmaceutically acceptable plasticizer. Suitable plasticizers include poloxamers (e.g., Kolliphor® P188, Kolliphor® P237, and Kolliphor® P407), polyethylene glycols (e.g., Kollisolv® PEG 300 and Kollisolv® PEG 400), polyvinyl acetate, stearic acid, glyceryl behenate, triacetin, diethyl phthalate, glyceryl monostearate, triethyl citrate, and macroglycerol hydroxystearate (e.g., Kolliphor® RH 40). In one embodiment, the plasticizer is selected from poloxamers, polyethylene glycols, polyvinyl acetate, and macroglycerol hydroxystearate. In a preferred embodiment, the plasticizer is selected from Kolliphor® P188, Kolliphor® P237, and Kolliphor® RH 40. In a more preferred embodiment, the plasticizer is a poloxamer, such as Kolliphor® P 188 or Kolliphor® P 237. Most preferably, the plasticizer is Kolliphor® P 188.
[0050] Experiments using Kolliphor® P188, Kolliphor® P237, or Kolliphor® RH 40 plasticizers to produce blank (i.e., drug-free) PLGA seeds by hot-melt extrusion showed that low loadings (5% w / w) resulted in seeds with inconsistent mean diameters, while high loadings (15-20% w / w) typically resulted in seeds that exhibited swelling when placed in water for up to 48 hours (see Comparative Example 1). Therefore, the optimal plasticizer loading is in the range of 5-15% w / w. In one embodiment, the seeds contain a loading of about 5-15% w / w, preferably about 10% w / w, of plasticizer based on the weight of the seed. In a preferred embodiment, the seeds contain Kolliphor® P188 based on the weight of the seed at a loading of about 10% w / w.
[0051] In one embodiment, the seed according to the present invention comprises a biodegradable polymer and a drug, and optionally a plasticizer.Therefore, in one aspect of the present invention, there is provided a chemotherapy seed comprising a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; the seed has a first length of at least 0.5 mm.In one embodiment, there is provided a chemotherapy seed comprising a biodegradable polymer (preferably PLGA) and a pharmaceutically acceptable salt of irinotecan (preferably irinotecan hydrochloride); the seed has a first length of at least 0.5 mm.In a preferred embodiment, there is provided a chemotherapy seed comprising a biodegradable polymer (preferably PLGA) and a pharmaceutically acceptable salt of irinotecan (preferably irinotecan hydrochloride); the seed has a first length of 1-4 mm. In a further aspect of the present invention, there is provided a chemotherapy seed comprising a biodegradable polymer, a plasticizer, and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; the seed having a first length of at least 0.5 mm. In one embodiment, there is provided a chemotherapy seed comprising a biodegradable polymer (preferably PLGA), a plasticizer (preferably Kolliphor® P 188), and a pharmaceutically acceptable salt of irinotecan (preferably irinotecan hydrochloride); the seed having a first length of at least 0.5 mm. In a preferred embodiment, there is provided a chemotherapy seed comprising a biodegradable polymer (preferably PLGA), a plasticizer (preferably Kolliphor® P 188), and a pharmaceutically acceptable salt of irinotecan (preferably irinotecan hydrochloride); the seed having a first length of 1 to 4 mm.
[0052] (Drug release profile) Irinotecan acts during the S phase of the cell cycle, which occurs around day 3, meaning that irinotecan's efficacy may be improved if therapeutic levels can be maintained at the tumor site for at least 5 to 7 days.
[0053] As described above, devices for the localized delivery of chemotherapeutic agents, such as irinotecan, directly to solid tumor resection sites may improve treatment outcomes by directly delivering higher doses of drug over the first 24–48 hours, followed by a slower, prolonged release of the drug for at least 5–7 days after device implantation. This release profile (an "initial burst" followed by sustained release) is particularly well-suited for the effective delivery of irinotecan to solid tumor resection sites because (i) the initial burst delivers a high, localized dose of drug, promoting diffusion of the drug through surrounding tissues and killing most of the remaining tumor cells not surgically removed, and (ii) the prolonged release provides a "top-up" of drug to kill cells in the G1 or G2 phase of the cell cycle that did not enter the S phase of the cell cycle until approximately day 3 after implantation.
[0054] The chemotherapy seeds of the present invention can provide the above drug release profile. Experiments conducted to measure the release of drug from the seeds into aqueous sinks and biorelevant media over a 7-day period show an initial burst of drug release by day 1, followed by a steady, slow release of drug up to day 7 after incubation (Example 9 and Figures 9-12).
[0055] Suitably, the "initial burst" release phase is defined as the seeds releasing 40% to 80% of the total amount of drug released after one day of incubation in an aqueous medium. More suitably, the "initial burst" is defined as the seeds releasing 50% to 75% of the total amount of drug released after one day of incubation in an aqueous medium.
[0056] Suitably, the "sustained release" phase is defined as the seeds releasing 20% to 60% of the drug, relative to the total amount of drug released, between 1 and 7 days after incubation in an aqueous medium. More suitably, "sustained release" is defined as the seeds releasing 25% to 50% of the drug, relative to the total amount of drug released, between 1 and 7 days after incubation in an aqueous medium.
[0057] An example of an in vitro test suitable for measuring the drug release profile of seeds according to the invention is described below in Example 9. Briefly, individual seeds (n=4) were placed in a sealed flask containing either 3 mL of water (a biorelevant medium designed to mimic cerebrospinal fluid) or 5 mL of phosphate-buffered (pH 7.4) saline (sink-conditioning medium) and placed in an orbital shaking incubator at 37°C and 60 rpm. Complete medium changes were performed on days 1, 2, 3, 4, and 7. Samples were filtered using a 0.45 μm filter and analyzed for IRN content using HPLC.
[0058] An aqueous physiological environment is defined as either a water-based medium in biologically relevant or sink conditions, as described above.
[0059] In one embodiment of the present invention, there is provided a seed as described herein that, when placed in an aqueous physiological environment, continuously releases drug for at least 3 days, at least 4 days, at least 5 days, at least 6 days, or at least 7 days.
[0060] In one embodiment, the seeds, when placed in an aqueous physiological environment, have a relative mass of released drug of: i. More than 20% of the drug after 1 day; ii. More than 30% of the drug after 3 days; iii. More than 40% of the drug after 5 days; and / or iv. More than 50% of the drug after 7 days is released.
[0061] In one embodiment, the seeds, when placed in an aqueous physiological environment, have a relative mass of released drug of: i. More than 40% of the drug after 1 day; ii. More than 50% of the drug after 3 days; iii. >60% drug after 5 days; and / or iv. >70% of the drug after 7 days is released.
[0062] In one embodiment, the seeds, when placed in an aqueous physiological environment, have a relative mass of released drug of: i. More than 50% of the drug after 1 day; ii. >60% drug after 3 days; iii. >70% drug after 5 days; and / or iv. >80% of the drug after 7 days is released.
[0063] In one embodiment, the seeds, when placed in an aqueous physiological environment, have a total amount of drug released after 7 days of: i. up to 80% of the drug after 1 day; and / or ii. Up to 95% of the drug after 3 days is released.
[0064] In one embodiment, the seeds, when placed in an aqueous physiological environment, have a total amount of drug released after 7 days of: i. up to 75% of the drug after 1 day; and / or ii. Up to 95% of the drug after 3 days is released.
[0065] In one embodiment, the seeds, when placed in an aqueous physiological environment, have a total amount of drug released after 7 days of: i. up to 65% of the drug after 1 day; and / or ii. Up to 85% of the drug after 3 days is released.
[0066] In one embodiment, the seeds, when placed in an aqueous physiological environment, have a total amount of drug released after 7 days of: i. 40-80% of the drug after 1 day; ii. 50-95% of the drug after 3 days; and / or iii. 60-100% of the drug after 5 days is released.
[0067] In one embodiment, the seeds, when placed in an aqueous physiological environment, have a total amount of drug released after 7 days of: i. 50-75% of the drug after 1 day; ii. 60-95% of the drug after 3 days; and / or iii. 70-100% of the drug after 5 days is released.
[0068] In one embodiment, the seeds, when placed in an aqueous physiological environment, have a total amount of drug released after 7 days of: i. 60-70% of the drug after 1 day; ii. 70-90% of the drug after 3 days; and / or iii. 80-100% of the drug after 5 days is released.
[0069] In one embodiment, when the seeds are placed in an aqueous physiological environment, the cumulative drug release is 1-6 mg after 1 day and 1-7.5 mg after 3 days. In one embodiment, when the seeds are placed in an aqueous physiological environment, the cumulative drug release is 1-6 mg after 1 day; 1-7.5 mg after 3 days; and 2-10 mg after 7 days.
[0070] In one embodiment, the seeds, when placed in an aqueous physiological environment, release at least 300-1000 μg of drug per day for at least 5 days, at least 6 days, or at least 7 days. In a further embodiment, the seeds, when placed in an aqueous physiological environment, release at least 300-1000 μg of irinotecan (or a pharmaceutically acceptable salt thereof) per day for at least 5 days, at least 6 days, or at least 7 days. In yet a further embodiment, the seeds, when placed in an aqueous physiological environment, release 2000-5000 μg of irinotecan (or a pharmaceutically acceptable salt thereof) after one day, followed by at least 300 μg of irinotecan (or a pharmaceutically acceptable salt thereof) per day for six consecutive days.
[0071] In one embodiment, the seeds comprise 30-40% w / w irinotecan hydrochloride, and when placed in an aqueous physiological environment, the seeds release, with respect to the total amount of irinotecan released after 7 days: i. 40-70% irinotecan after 1 day; ii. 60-90% irinotecan after 3 days; and / or iii. 70-100% irinotecan after 5 days is released.
[0072] In one embodiment, the seeds have a first length of about 2 mm and comprise 30-40% w / w irinotecan hydrochloride, and when placed in an aqueous physiological environment, the seeds have a relative release rate of: i. 40-70% irinotecan after 1 day; ii. 60-90% irinotecan after 3 days; and / or iii. 70-100% irinotecan after 5 days is released.
[0073] In one embodiment, the seeds have a first length of about 2 mm, a second length of about 3-6 mm, and contain 30-40% w / w irinotecan hydrochloride, and when placed in an aqueous physiological environment, the seeds release irinotecan at a total dose of: i. 40-70% irinotecan after 1 day; ii. 60-90% irinotecan after 3 days; and / or iii. 70-100% irinotecan after 5 days is released.
[0074] In any of the above embodiments, placing the seeds in an aqueous physiological environment may refer to incubating the seeds in 5 mL of phosphate buffered (pH 7.4) saline at 37°C with agitation at 60 rpm, with complete medium changes occurring on days 1, 2, 3, 4, and 7 after incubation. In any of the above embodiments, placing the seeds in an aqueous physiological environment may refer to incubating the seeds in 3 mL of water at 37°C with agitation at 60 rpm, with complete medium changes occurring on days 1, 2, 3, 4, and 7 after incubation.
[0075] In one embodiment, when incubated in 5 mL of pH 7.4 phosphate buffered saline at 37° C. with agitation at 60 rpm, with complete medium changes performed on days 1, 2, 3, 4, and 7 after incubation, the seeds have a total released amount of irinotecan of: i. 50-75% of the drug after 1 day; ii. 60-95% of the drug after 3 days; and / or iii. 70-100% of the drug after 5 days is released.
[0076] In one embodiment, when incubated in 5 mL of pH 7.4 phosphate buffered saline at 37°C with agitation at 60 rpm, with complete medium changes on days 1, 2, 3, 4, and 7 after incubation, the seeds release at least 300-1000 μg of drug per day for at least 5 days, at least 6 days, or at least 7 days.
[0077] In any of the above embodiments describing a drug release profile, the term "drug" can refer to irinotecan (or a pharmaceutically acceptable salt thereof), or a derivative of irinotecan (or a pharmaceutically acceptable salt thereof). Preferably, "drug" refers to irinotecan (or a pharmaceutically acceptable salt thereof).
[0078] (composition) In one aspect of the present invention, there is provided a pharmaceutical composition comprising one or more seeds as described herein. In one embodiment, the pharmaceutical composition comprises 10 to 100 seeds as described herein. In a preferred embodiment, the pharmaceutical composition comprises 30 to 60 seeds as described herein.
[0079] In one embodiment, the pharmaceutical composition comprises one or more seeds, each seed having a first length of at least 0.5 mm and comprising a biodegradable polymer having dispersed therein a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan.
[0080] In one embodiment, the pharmaceutical composition comprises one or more seeds, each seed having a first length of about 2 mm and comprising PLGA having irinotecan hydrochloride dispersed therein.
[0081] In one embodiment, the pharmaceutical composition comprises one or more seeds, each seed having a first length of about 2 mm and a second length of about 3-6 mm, and comprising PLGA having irinotecan hydrochloride dispersed therein.
[0082] In one embodiment, the pharmaceutical composition comprises one or more seeds, each seed having a first length of about 2 mm and a second length of about 3-6 mm, and comprising PLGA (e.g., 50:50 w / w LA:GA) having 30-40% w / w irinotecan hydrochloride dispersed therein.
[0083] The compositions of the present invention may contain one or more additional therapeutic agents. The additional therapeutic agents may have anti-cancer effects or any other therapeutic effects, such as antibiotics, anti-inflammatory agents, anticoagulants, analgesics, statins, antiplatelet agents, antifungals, angiotensin-converting enzyme (ACE) inhibitors, acetaldehyde dehydrogenase inhibitors, or other suitable complementary therapeutic agents. In one embodiment, the composition further contains an additional anti-cancer agent. In one embodiment, the one or more additional therapeutic agents are selected from anti-cancer agents (e.g., bevacizumab), statins (e.g., pitavastatin), antiplatelet agents (e.g., ticlopidine), antifungals (e.g., itraconazole), angiotensin-converting enzyme (ACE) inhibitors (e.g., captopril), acetaldehyde dehydrogenase inhibitors (e.g., disulfiram), and anti-inflammatory agents (e.g., celecoxib).
[0084] In one embodiment, a pharmaceutical composition is provided comprising one or more seeds described herein and a statin (e.g., pitavastatin). In one embodiment, a pharmaceutical composition is provided comprising one or more seeds described herein and an angiotensin-converting enzyme (ACE) inhibitor (e.g., captopril). In one embodiment, a pharmaceutical composition is provided comprising one or more seeds described herein and an acetaldehyde dehydrogenase inhibitor (e.g., disulfiram). In one embodiment, a pharmaceutical composition is provided comprising one or more seeds described herein, a statin (e.g., pitavastatin), and an angiotensin-converting enzyme (ACE) inhibitor (e.g., captopril). In one embodiment, a pharmaceutical composition is provided comprising one or more seeds described herein, a statin (e.g., pitavastatin), and an acetaldehyde dehydrogenase inhibitor (e.g., disulfiram). In one embodiment, a pharmaceutical composition is provided comprising one or more seeds described herein, an angiotensin-converting enzyme (ACE) inhibitor (e.g., captopril), and an acetaldehyde dehydrogenase inhibitor (e.g., disulfiram).
[0085] In one embodiment, the additional anti-cancer agent comprises one or more radioisotopes suitable for the treatment of cancer. Alternatively, the additional therapeutic agent is a radiosensitizer for concurrent or subsequent radiotherapy treatment.
[0086] The additional therapeutic agent can be mixed with the seed in the composition. Alternatively, in one embodiment, the seed can comprise two layers, where the first layer comprises a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; and the second layer comprises an additional therapeutic agent. The seed can further comprise an additional layer and / or an additional therapeutic agent. In one embodiment, all layers are made of biodegradable polymers, such as PLGA. In another embodiment, the first layer is made of one biodegradable polymer, such as PLGA, and the second layer is made of a different biodegradable polymer. In one embodiment, seeds according to the present invention are provided, further comprising one or more additional therapeutic agents selected from an anticancer agent (e.g., bevacizumab), a statin (e.g., pitavastatin), an antiplatelet agent (e.g., ticlopidine), an antifungal agent (e.g., itraconazole), an angiotensin-converting enzyme (ACE) inhibitor (e.g., captopril), an acetaldehyde dehydrogenase inhibitor (e.g., disulfiram), an anti-inflammatory agent (e.g., celecoxib), and copper gluconate. In one embodiment, seeds according to the present invention are provided, further comprising pitavastatin. In one embodiment, seeds according to the present invention are provided, further comprising captopril and disulfiram. In one embodiment, seeds according to the present invention are provided, further comprising captopril, celecoxib, and itraconazole. In one embodiment, seeds according to the present invention are provided, further comprising captopril, pitavastatin, and ticlopidine. In one embodiment, seeds according to the present invention are provided, further comprising pitavastatin, disulfiram, and copper gluconate.
[0087] Pitavastatin refers to the compound having the following structure ((3R,5S,6E)-7-[2-cyclopropyl-4-(4-fluorophenyl)quinolin-3-yl]-3,5-dihydroxyhept-6-enoic acid) and pharmaceutically acceptable salts thereof: [ka]
[0088] Conveniently, pitavastatin herein refers to the calcium salt of the above compound, i.e., calcium bis((3R,5S,6E)-7-[2-cyclopropyl-4-(4-fluorophenyl)quinolin-3-yl]-3,5-dihydroxyhept-6-enoate).
[0089] In another embodiment, the composition comprises seeds comprising: a) a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; and b) an additional therapeutic agent (e.g., one of the therapeutic agents listed above); The composition comprises one or more seeds, each of which comprises a layer of a biodegradable polymer having dispersed therein a biodegradable polymer.
[0090] In one embodiment, the composition comprises each seed comprising: a) in the first layer, a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; and b) In the second tier, an additional therapeutic agent (e.g., one of the therapeutic agents listed above). The composition comprises one or more seeds, each of which comprises two layers of a biodegradable polymer having dispersed therein a biodegradable polymer.
[0091] In one embodiment, the composition comprises each seed comprising: a) in the first layer, a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; and b) In the second layer, pitavastatin The composition comprises one or more seeds, each of which comprises two layers of a biodegradable polymer having dispersed therein a biodegradable polymer.
[0092] In one embodiment, the composition comprises each seed comprising: a) in the first layer, irinotecan hydrochloride; and b) In the second layer, pitavastatin The composition comprises one or more seeds, each of which comprises two layers of a biodegradable polymer having dispersed therein a biodegradable polymer.
[0093] In one embodiment, the composition comprises each seed comprising: a) in the first layer, irinotecan hydrochloride; and b) In the second layer, pitavastatin The LA:GA mixture contains one or more seeds, each containing two layers of PLGA (e.g., 50:50 w / w LA:GA) with LA dispersed therein.
[0094] In one embodiment, the composition comprises each seed comprising: a) 30-40% w / w irinotecan hydrochloride in the first layer; and b) In the second layer, 10-50% (e.g., 20-40%) w / w pitavastatin The LA:GA mixture contains one or more seeds, each containing two layers of PLGA (e.g., 50:50 w / w LA:GA) with LA dispersed therein.
[0095] In one embodiment, the composition comprises each seed having a first length of about 2 mm and a second length of about 6 mm: a) 30-40% w / w irinotecan hydrochloride in the first layer; and b) In the second layer, 10-50% (e.g., 20-40%) w / w pitavastatin The LA:GA mixture contains one or more seeds, each containing two layers of PLGA (e.g., 50:50 w / w LA:GA) with LA dispersed therein.
[0096] In one embodiment, the composition comprises each seed having a first length of about 2 mm and a second length of about 6 mm: a) 30-40% w / w irinotecan hydrochloride in the first layer; and b) In the second layer, 10-50% (e.g., 20-40%) w / w pitavastatin The membrane comprises two layers of PLGA (e.g., 50:50 w / w LA:GA) dispersed therein, each of the two layers containing one or more seeds having a first length of about 2 mm and a second length of about 3 mm.
[0097] (therapeutic use) In one aspect of the present invention, there is provided a seed as described herein for use in therapy. In one embodiment, there is provided a seed as described herein for use in treating a disease or condition treatable with a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan.
[0098] Also provided is a method of administering a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan to a warm-blooded animal (preferably a human), the method comprising implanting one or more seeds described herein into the warm-blooded animal.
[0099] In a further aspect of the present invention, the seed herein is provided for use in cancer treatment.In a further aspect of the present invention, the seed herein is provided for use in solid tumor treatment.In one embodiment, cancer is a solid tumor selected from colorectal cancer, prostate cancer, pancreatic cancer, breast cancer, liver cancer, ovarian cancer, bladder cancer, lung cancer (including small cell lung cancer) or brain cancer.In a preferred embodiment, the seed herein is provided for use in brain tumor treatment; preferably, the brain tumor is high-grade (grade III and IV) glioma.In one embodiment, the seed is for use in treating grade IV glioma (for example, glioblastoma multiforme).
[0100] The chemotherapy seeds of the present invention, or compositions containing them, may enhance the effects of conventional chemotherapy, radiation therapy, immunotherapy, hormone therapy or gene therapy.
[0101] The chemotherapy seeds of the present invention or compositions containing them can be directly placed in solid tumors or injected around solid tumors.Preferably, they can be placed in the resection cavity created after surgical debulking of solid tumors.In one embodiment, the seeds herein are provided for use in the treatment of solid tumors, and the treatment comprises implanting one or more seeds into the resection margin of debulked tumors.Alternatively, they can be inserted intratumorally into unresectable tumors by stereotaxy.In a preferred embodiment, the seeds herein are provided for use in the treatment of brain tumors (preferably high-grade gliomas (grade III and IV)), and the treatment comprises implanting seeds into the resection margin of debulked brain tumors.
[0102] Also provided is a method of treating brain tumors (preferably high-grade gliomas (grade III and IV)), wherein the treatment comprises implanting seeds as described herein in or around the brain tumor (preferably, the treatment comprises implanting seeds into the resection margins of a debulked brain tumor).
[0103] Due to the size of the seeds described herein, it is envisioned that the seeds can be administered to the tumor site via a catheter or needle. In one embodiment, the seeds according to the present invention, or a composition comprising one or more of the seeds, are administered via a catheter or needle.
[0104] (Manufacturing chemotherapy seeds) The chemotherapy seeds described herein can be manufactured by any suitable method, including compression, solvent casting, thermoforming, injection molding, extrusion or 3D printing.The properties of the biodegradable polymer and / or drug may influence the selection of the manufacturing method.Preferably, the chemotherapy seeds described herein are manufactured by hot melt extrusion.
[0105] According to a further aspect of the present invention, a method for producing ... a) feeding a drug and a biodegradable polymer into a hot melt extruder; b) extruding the mixture through an extruder; c) forming the extrudate of step b) into one or more seeds of required dimensions The present invention provides a method for producing the chemotherapy seeds described herein, comprising:
[0106] Preferably, the drug and biodegradable polymer are premixed before being placed in the hot melt extruder. Thus, in one embodiment, step a) comprises the steps of: a1) mixing a drug and a biodegradable polymer; and a2) feeding the mixture of step a1) into a hot melt extruder Includes.
[0107] The mixing in step a1) can be carried out by any conventional means, for example by using a pharmaceutical mixer or a high speed mixer.
[0108] If a plasticizer is a component of the seeds being produced, the plasticizer is also introduced during step a) of the above process.
[0109] Preferably, the hot melt extruder is a twin-screw co-rotating hot melt extruder. In one embodiment, the screw speed is 20 to 200 RPM, for example, 50 to 150 RPM, or preferably 80 to 120 RPM.
[0110] Typically, a hot melt extruder includes three zones: a feed zone, a mixing zone, and a metering or discharge zone. To allow efficient melting of the biodegradable polymer and uniform mixing with the drug particles without causing thermal degradation, the three zones are typically operated at different temperatures. In one embodiment, the feed zone is set at 25-175°C. In one embodiment, the mixing zone is set at 100-200°C. In one embodiment, the discharge zone is set at 50-150°C. In one embodiment, the feed zone is set at 25-175°C, the mixing zone is set at 100-200°C, and the discharge zone is set at 50-150°C.
[0111] In step b), the mixture is typically extruded from the discharge zone of the hot melt extruder through a die onto an output conveyor. After cooling on the output conveyor, the extrudate is solidified. Upon solidification, the extrudate can be formed into one or more seeds of the required size (step c). Typically, the extrudate is cut into seeds of the desired length (e.g., 1 to 10 mm, preferably 2 to 6 mm). The diameter of the seeds depends on the diameter of the die opening and the speed of the output conveyor. Preferably, the diameter of the seeds is 0.5 to 5 mm, e.g., 1 to 3 mm, or most preferably about 2 mm. In a preferred embodiment, the diameter of the die opening is 0.5 to 10 mm, e.g., 2 to 5 mm. In a preferred embodiment, the speed of the output conveyor is 50 to 250 RPM, e.g., 100 to 200 RPM. Preferably, the opening diameter of the die is 0.5 to 10 mm (for example, 2 to 5 mm), and the discharge conveyor speed is 50 to 250 RPM (for example, 100 to 200 RPM).
[0112] In one embodiment, the biodegradable polymer in step a) is PLGA, preferably the PLGA has a weight ratio of lactic acid:glycolic acid of about 50:50. In one embodiment, the drug in step a) is irinotecan hydrochloride. In a preferred embodiment, the biodegradable polymer in step a) is PLGA (preferably the PLGA has a weight ratio of lactic acid:glycolic acid of about 50:50), and the drug in step a) is irinotecan hydrochloride. In a preferred embodiment, the biodegradable polymer in step a) is ester end-capped PLGA and has a weight ratio of lactic acid:glycolic acid of about 50:50; and the drug in step a) is irinotecan hydrochloride. In a preferred embodiment, the biodegradable polymer in step a) is PLGA with an acid value of 1 mg KOH / g or less and a weight ratio of lactic acid:glycolic acid of about 50:50; and the drug in step a) is irinotecan hydrochloride.
[0113] In a preferred embodiment, there is provided a method for producing a chemotherapy seed as described herein, comprising PLGA and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan, the method comprising the steps of: a) charging a drug (preferably irinotecan hydrochloride) and PLGA (preferably 50:50 w / w LA:GA) into a hot melt extruder; b) extruding the mixture through an extruder at a screw speed of 90-110 RPM; and c) forming the extrudate of step b) into one or more seeds of required dimensions wherein the hot melt extruder has a feed zone set at 50-150°C (e.g., 150°C), a mixing zone set at 125-155°C (e.g., 150°C), and a discharge zone set at 70-110°C (e.g., 100°C). In a further embodiment where the seeds further comprise a plasticizer, the screw speed is about 100 RPM and the mixing zone is set at about 150°C. In yet another embodiment where the seeds do not comprise a plasticizer, the screw speed is about 90 RPM and the mixing zone is set at about 130°C.
[0114] In a further embodiment, there is provided a method for producing a chemotherapy seed described herein comprising PLGA, irinotecan hydrochloride, and an additional therapeutic agent, the method comprising the steps of: a) introducing irinotecan hydrochloride, an additional therapeutic agent, and PLGA into a hot melt extruder; b) extruding the mixture through an extruder; c) forming the extrudate of step b) into one or more seeds of required dimensions The present invention provides a method of manufacturing a semiconductor device, comprising:
[0115] In a further embodiment, there is provided a method for producing a chemotherapy seed described herein comprising PLGA, irinotecan hydrochloride, and an additional therapeutic agent, wherein the seed comprises two layers, a first layer containing irinotecan hydrochloride; and a second layer containing the additional therapeutic agent; the method comprising the steps of: a) charging irinotecan hydrochloride and PLGA into a hot melt extruder; b) extruding the mixture through an extruder; c) forming the extrudate of step b) into one or more seeds of required dimensions; d) adding the additional therapeutic agent and PLGA to the hot melt extruder; e) extruding the mixture through an extruder; f) forming the extrudate of step e) into one or more seeds of required dimensions; g) physically bonding the seed of step c) to the seed of step f) to form a seed comprising two layers. The present invention provides a method of manufacturing a semiconductor device, comprising:
[0116] In the above embodiment, preferably in step c) and / or step f), the extrudate is cut into seeds of a desired length (e.g., 1-10 mm, preferably about 3 mm). In the above embodiment, preferably in step c) and / or step f), the extrudate is formed into seeds about 2 mm in diameter. In the above embodiment, preferably in step c) and / or step f), the extrudate is formed into seeds about 2 mm in diameter and about 3 mm in length. In the above embodiment, preferably in step d), the further therapeutic agent is pitavastatin. In the above embodiment, preferably in step g), physical attachment of the seeds is achieved by butt welding.
[0117] In one aspect of the present invention, there are provided chemotherapy seeds obtained or obtainable by the manufacturing methods described herein. In one embodiment, there are provided chemotherapy seeds obtained or obtainable by the hot melt extrusion methods described herein.
[0118] Throughout the description and claims of this specification, the terms "comprise" and "contain" and variations thereof mean "including, but not limited to," and are not intended to (and do not) exclude other moieties, adjuncts, components, integers, or steps. Throughout the description and claims of this specification, the singular encompasses the plural unless the context otherwise requires. In particular, when the indefinite article is used, the specification should be understood to contemplate the plural as well as the singular, unless the context otherwise requires.
[0119] The following numbered statements 1-55 are not claims but instead various aspects and embodiments of the invention: 1. A chemotherapy seed comprising a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; the seed having a first length of at least 0.5 mm. 2. The seed of statement 1, wherein the biodegradable polymer is a lactic acid-glycolic acid copolymer or polylactic acid. 3. The seed of statement 2, wherein the polymer is endcapped with either an acid or an ester group. 4. The seed of statement 1, wherein the biodegradable polymer is a lactic acid-glycolic acid copolymer. 5. The seed of statement 4, wherein the lactic acid-glycolic acid copolymer is end-capped with an ester group. 6. A seed according to any one of statements 1-2 or 4-5, wherein the biodegradable polymer has an acid value of 1 mg KOH / g or less. 7. A seed according to any one of statements 4 to 6, wherein the lactic acid weight content of the lactic acid-glycolic acid copolymer is about 5 to 95%, with the remainder being glycolic acid. 8. The seed of statement 7, wherein the lactic acid-glycolic acid copolymer has a weight ratio of lactic acid:glycolic acid of about 5:95, about 15:85, about 25:75, about 40:60, about 50:50, about 60:40, about 75:25, about 85:15, or about 95:5. 9. The seed of statement 8, wherein the lactic acid-glycolic acid copolymer has a weight ratio of lactic acid:glycolic acid of about 50:50. 10. A seed according to any one of statements 4 to 9, wherein the lactic acid-glycolic acid copolymer has an intrinsic viscosity of 0.15 to 1.2 dL / g when measured at 25°C in chloroform at a concentration of 0.5 g / dL. 11. The seed of any of statements 4-6, wherein the lactic acid-glycolic acid copolymer has a weight ratio of lactic acid:glycolic acid of about 50:50 and an intrinsic viscosity of 0.3-0.5 dL / g when measured at 25°C in chloroform at a concentration of 0.5 g / dL. 12. The seed of any of statements 1-11, wherein the drug is present at a loading of 1-50% by weight based on the weight of the seed. 13. The seed of statement 12, wherein the drug is present at a loading of 25-45% by weight based on the weight of the seed. 14. The seed of statement 12, wherein the drug is present in a loading amount of about 30% or about 40% by weight based on the weight of the seed. 15. A seed according to any one of statements 1 to 14, wherein the drug is a pharmaceutically acceptable salt of irinotecan. 16. The seed of statement 15, wherein the drug is irinotecan hydrochloride. 17. A seed according to any one of statements 1 to 16, wherein the seed has a first length of 1 to 4 mm. 18. The seed of statement 17, wherein the seed has a first length of about 2 mm. 19. The seed of any of statements 1-18, wherein the seed has a second length of 2-6 mm. 20. The seed of statement 19, wherein the seed has a second length of about 2 mm, about 3 mm, about 4 mm, about 5 mm, or about 6 mm. 21. The seed of statement 19 or 20, wherein the seed is substantially cylindrical, the first length is the seed diameter, and the second length is the seed length. 22. The seed of statement 21, wherein the seed has a first length of about 2 mm and a second length of about 3 mm or about 6 mm. 23. The seed of any one of statements 1-21, wherein the seed further comprises a pharmaceutically acceptable plasticizer. 24. The seed of statement 23, wherein the plasticizer is selected from poloxamer, polyethylene glycol, polyvinyl acetate, and macroglycerol hydroxystearate. 25. The seed according to statement 24, wherein the plasticizer is a poloxamer, for example Kolliphor® P 188 or Kolliphor® P 237. 26. The seed of any of statements 23-25, wherein the plasticizer is present in the seed at a loading of about 10% to about 20% by weight, based on the weight of the seed. 27. The seeds of statement 26, wherein the seeds are present in Kolliphor® P 188 at a loading of about 10% by weight based on the weight of the seeds. 28. The seed of any one of statements 1 to 22, wherein the seed does not contain a plasticizer. 29. A chemotherapy seed comprising a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; the seed having a first length of at least 0.5 mm. 30. A seed according to any of statements 1-29, wherein the seed releases drug continuously for at least 3 days, at least 4 days, at least 5 days, at least 6 days, or at least 7 days when placed in an aqueous physiological environment. 31. When seeds are placed in an aqueous physiological environment, the total amount of drug released is: i. More than 50% of the drug after 1 day; ii. >60% drug after 3 days; iii. >70% of the drug after 5 days; or iv. >80% of the drug after 7 days 31. The seed of any one of statements 1 to 30, wherein the seed releases 32. When seeds are placed in an aqueous physiological environment, the total amount of drug released after 7 days is: i. up to 75% of the drug after 1 day; and / or ii. Up to 95% of the drug after 3 days 32. The seed of any one of statements 1 to 31, which releases 33. When seeds are placed in an aqueous physiological environment, the total amount of drug released after 7 days is: i. up to 65% of the drug after 1 day; and / or ii. Up to 85% of the drug after 3 days 33. The seed of statement 32, wherein the seed releases 34. When seeds are placed in an aqueous physiological environment, the total amount of drug released after 7 days is: i. 20-60% of the drug after 1 day; ii. 30-75% of the drug after 3 days; and / or iii. 50-100% drug recovery after 5 days 31. The seed of any one of statements 1 to 30, wherein the seed releases 35. When seeds are placed in an aqueous physiological environment, the total amount of drug released after 7 days is: i. 40-80% of the drug after 1 day; ii. 50-95% of the drug after 3 days; and / or iii. 60-100% of the drug after 5 days 31. The seed of any one of statements 1 to 30, wherein the seed releases 36. A seed according to any of statements 1 to 35, wherein when the seed is placed in an aqueous physiological environment, the cumulative drug release is 1 to 6 mg after 1 day; 1 to 7.5 mg after 3 days; and 2 to 10 mg after 7 days. 37. A seed according to any of statements 1-30, wherein the seed releases at least 300-1000 μg of drug per day for at least 5 days, at least 6 days, or at least 7 days when placed in an aqueous physiological environment. 38. The seed of any of statements 1-37, wherein the seed further comprises one or more additional therapeutic agents selected from an anti-cancer agent (e.g., bevacizumab), a statin (e.g., pitavastatin), an antiplatelet agent (e.g., ticlopidine), an anti-fungal agent (e.g., itraconazole), an angiotensin-converting enzyme (ACE) inhibitor (e.g., captopril), an inhibitor of the enzyme acetaldehyde dehydrogenase (e.g., disulfiram), an anti-inflammatory agent (e.g., celecoxib), and copper gluconate. 39. The seed of statement 38, wherein the seed comprises two layers, a first layer comprising a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; and a second layer comprising a biodegradable polymer and an additional therapeutic agent. 40. The seed of statement 38, wherein the seed comprises two layers, a first layer comprising a biodegradable polymer and irinotecan hydrochloride; and a second layer comprising a biodegradable polymer and pitavastatin. 41. The seed of statement 38, wherein the seed comprises two layers, a first layer comprising PLGA (e.g., about 50:50 w / w LA:GA) and irinotecan hydrochloride; and a second layer comprising PLGA (e.g., about 50:50 w / w LA:GA) and pitavastatin. 42. The seed of claim 40 or 41, wherein the loading of irinotecan hydrochloride in the first layer is about 30-40% w / w; and the loading of pitavastatin in the second layer is about 10-50% w / w (e.g., 20-40% w / w). 43. A seed according to any of statements 39-42, wherein each of the two layers has a first length of about 2 mm and a second length of about 3 mm. 44. A pharmaceutical composition comprising one or more seeds according to any one of statements 1 to 43. 45. A pharmaceutical composition comprising 10 to 100 seeds (e.g., 30 to 60 seeds) according to any one of statements 1 to 43. 46. The pharmaceutical composition of statement 44 or 45, wherein the composition further comprises one or more additional therapeutic agents. 47. The pharmaceutical composition of statement 46, wherein the one or more additional therapeutic agents are selected from anticancer agents, statins, antiplatelet agents, antifungals, angiotensin-converting enzyme (ACE) inhibitors, enzyme acetaldehyde dehydrogenase inhibitors, and anti-inflammatory agents. 48. A seed according to any one of statements 1 to 43 or a pharmaceutical composition according to any one of statements 45 to 47 for use in therapy. 49. A seed according to any one of statements 1 to 43 or a pharmaceutical composition according to any one of statements 45 to 47 for use in the treatment of brain tumors. 50. A seed or pharmaceutical composition for use according to statement 49, wherein the brain tumor is a high-grade glioma. 51. A seed or pharmaceutical composition for use according to statement 49 or 50, wherein the treatment comprises implanting the seed or pharmaceutical composition into the resection margins of a debulked brain tumor. 52. The following process: a) feeding a drug and a biodegradable polymer into a hot melt extruder; b) extruding the mixture through an extruder; c) forming the extrudate of step b) into one or more seeds of required dimensions A method for producing a chemotherapy seed according to any one of statements 1 to 43, comprising: 53. The method of manufacturing of statement 52, wherein the biodegradable polymer of step a) is PLGA. 54. The process of claim 52 or 53, wherein the drug in a) is irinotecan hydrochloride. 55. A chemotherapy seed obtained or obtainable by the manufacturing method described in any of statements 52 to 54. [Example]
[0120] The invention will now be described in more detail with reference to the following illustrative examples. (abbreviation) DCM dichloromethane DMEM Dulbecco's Modified Eagle's Medium GBM Glioblastoma multiforme HME Hot Melt Extrusion HPLC High Performance Liquid Chromatography IRN Irinotecan IRN HCl Irinotecan hydrochloride NIH National Institutes of Health PBS Phosphate-buffered saline PLGA lactic acid-co-glycolic acid PSI pounds per square inch PVT Pitavastatin RPM Revolutions per minute TMZ Temozolomide
[0121] Materials and Equipment Polylactic acid-co-glycolic acid (PLGA) (PURASORB PDLG) with a 50:50 lactide:glycolide ratio was purchased from Corbion (Amsterdam, The Netherlands). Samples "5002," "5004," and "5010" were described as having intrinsic viscosities of 0.16-0.24 dL / g, 0.32-0.48 dL / g, and 0.8-1.2 dL / g, respectively, when measured in chloroform at a concentration of 0.5 g / dL at 25°C. "5002" PLGA was acid end-capped (acid value ≥ 6 mg KOH / g), while "5004" and "5010" PLGA samples were ester end-capped (acid value ≤ 1 mg KOH / g). Irinotecan hydrochloride (IRN HCl) was purchased from LGM Pharma (Nashville, TN). Pitavastatin (calcium salt) was purchased from LGM Pharma (Nashville, TN). Temozolomide, Kolliphor® P188, acetonitrile, dichloromethane, and sodium phosphate were purchased from Sigma-Aldrich (Dorset, England). Kolliphor® plasticizers RH40 and P237 were purchased from BASF (Ludwigshafen, Germany). GBM cell lines were obtained from patients undergoing resection surgery at Queen Elizabeth Hospital, Birmingham, UK.
[0122] Hot melt extrusion was carried out using a 10 mm 40:1 microlab twin co-rotating screw extruder (Rondol Technology, Stoke-on-Trent, UK).
[0123] Confocal Raman spectroscopy was used to detect and spatially resolve the IRN distribution within the extruded PLGA polymer block. Maps and spectra were acquired using a confocal Raman microscope (Alpha300R, WITec, Ulm, Germany) equipped with an Acton SP2300 Imaging Monochromator / Spectrograph (Princeton Instruments, MA, USA) equipped with a 300 g / mm 750 nm blazed grating and a 785 nm 250 mW diode laser (XTRA II, Toptica photonics, Munich, Germany). Raman maps were acquired in continuous scan mode using a 20X (NA = 0.45) objective with a 1 s integration time and a scan area of 5 mm width and 2 mm height. Data were accumulated and exported to .spc files using WITec Control software version 1.6 (WITec, Ulm, Germany) and subsequently processed using our in-house MATALB Raman data processing tool. The imported hyperspectral datasets were baseline corrected before applying vector normalization and finally generating the IRN and PLGA maps.
[0124] (General Method for Preparing IRN HCl-Loaded Biodegradable Polymer Seeds) IRN HCl-loaded biodegradable polymer seeds are prepared by mixing IRN HCl with the biodegradable polymer using a pharmaceutical mixer or high-speed mixer. Depending on the weight percent of IRN HCl in the implant, the addition of a plasticizer may be necessary. The mixture is then fed into the barrel of a hot-melt extruder. The biodegradable polymer (and optional plasticizer) is allowed to soften and / or melt, allowing the IRN HCl or its derivatives to become incorporated into the biodegradable polymer matrix. The mixture exits the hot-melt extruder through a die, whereby the diameter of the extrudate strand is controlled using the exit conveyor speed. Upon cooling, the extrudate is cut into one or more seeds of the required size.
[0125] Comparative Example 1: Preparation of blank PLGA seeds to evaluate the effect of plasticizers on seed diameter consistency and swelling resistance The appropriate amounts of PLGA polymer and plasticizer (5, 10, 15, and 20% w / w) (either Kolliphor® P188, Kolliphor® P237, or Kolliphor® RH40) were weighed into a sealed plastic container and tumble mixed for 10 minutes. The active mixture was then fed into a 40:1 microlab extruder at a feed rate of 90 g per hour. The feed, mixing, and metering zones of the extruder were set at 45°C, 110°C, and 70°C, respectively. The melt was extruded through a 2 mm die and subsequently cut into 6 mm long blank PLGA seeds.
[0126] To determine the diameter and weight of blank seeds, samples of each blank seed (n=10) were evaluated for average weight and diameter. Each seed was measured at its center and both ends using digital calipers. The three measurements were averaged to obtain the diameter of each individual blank seed. The results are shown in Figure 1A. Higher plasticizer loadings produced seeds with a more consistent diameter; Kolliphor® P188 and RH 40 required a minimum loading of 10% w / w to produce seeds of consistent diameter, while Kolliphor® P237 required a minimum loading of 15% w / w.
[0127] To examine the effect of plasticizer type and loading dose on blank seed swelling, each blank seed (n = 4) was placed in a glass vial containing 3 ml of distilled water and placed in an orbital shaking incubator (Infors HT) at 37 °C and 60 RPM. Their length and width were measured using digital calipers at 0, 0.5, 1, 2, 4, 6, 24, and 48 h after incubation. The RH 40 plasticizer resulted in significant swelling (P = 0.025) at all loading doses (Figure 1B). The P188 and P237 plasticizers showed significant swelling (P = 0.019) at 15 and 20% w / w loading doses (Figures 1C and 1D). Based on the data shown in Figure 1, the preferred plasticizer in terms of consistent seed diameter and resistance to swelling was P188 at 10% w / w loading.
[0128] Example 1: Preparation of IRN HCl-loaded PLGA seeds 10 wt% seeds were prepared by mixing 1 g of IRN HCl with 9 g of "5004" PLGA. 20 wt% seeds were prepared by mixing 2 g of IRN HCl with 8 g of "5004" PLGA. 30 wt% seeds were prepared by mixing 3 g of IRN HCl with 7 g of "5004" PLGA.
[0129] Each mixture was individually fed into the barrel of a hot-melt extruder. For all mixtures, the feed rate was set at 4.5 g / min, and the extruder screw speed was set at 90 RPM. The hot-melt extruder barrel had three heating zones: Heating Zone 1 (feed zone) was set at 45 °C, Heating Zone 2 (mixing zone) was set at 130 °C, and Heating Zone 3 (discharge zone) was set at 100 °C. The extruder torque ranged from 4 to 8 N·m, depending on the composition of the mixture fed into the extruder. The extruder die was 4 mm, and the discharge conveyor was set at 150 RPM to maintain an extrudate diameter of 2 mm. Once solidified, the extrudate was cut into 3 mm long seeds. Extrudate containing 30 wt% IRN HCl was also cut into 2 mm or 6 mm long seeds.
[0130] FIG. 2 shows the appearance of a 30 wt % IRN HCl seed with a diameter of 2 mm and a length of 6 mm.
[0131] Example 2: Preparation of IRN HCl-loaded PLGA seeds containing 10 wt% plasticizer 30 wt% seeds were made by mixing 3 g of IRN HCl with 6 g of "5004" PLGA and 1 g of Kolliphor® P188 plasticizer. 40 wt% seeds were made by mixing 4 g of IRN HCl with 5 g of "5004" PLGA and 1 g of Kolliphor® P188 plasticizer. 50 wt% seeds were made by mixing 5 g of IRN HCl with 4 g of "5004" PLGA and 1 g of Kolliphor® P188 plasticizer.
[0132] Each mixture was individually fed into the barrel of a hot-melt extruder. For all mixtures, the feed rate was set at 4.5 g / min, and the extruder screw speed was set at 100 RPM. The hot-melt extruder barrel had three heating zones: Heating Zone 1 (feed zone) was set at 45 °C, Heating Zone 2 (mixing zone) was set at 100 °C, and Heating Zone 3 (discharge zone) was set at 70 °C. The extruder torque ranged from 4 to 8 N·m, depending on the composition of the mixture fed into the extruder. The extruder die was 4 mm, and the discharge conveyor was set at 150 RPM to maintain an extrudate diameter of 2 mm. Once solidified, the extrudate was cut into 2- or 3-mm-long seeds.
[0133] Example 3: Another preparation of 30 wt% IRN HCl-loaded PLGA seeds without plasticizer 30 wt % IRN HCl-loaded PLGA seeds with a diameter of 2 mm and a length of 6 mm were prepared according to Example 2 under the following hot melt extrusion parameters: (A) 10% plasticizer; 100 RPM screw speed; 150°C mixing temperature (comparative sample containing plasticizer) (B) 0% plasticizer; 100 RPM screw speed; 150°C mixing temperature; (C) 0% plasticizer; 90 RPM screw speed; 150°C mixing temperature; (D) 0% plasticizer; 90 RPM screw speed; 140°C mixing temperature; and (E) 0% plasticizer; 90 RPM screw speed; 130°C mixing temperature.
[0134] Example 4: Preparation of 30 wt% IRN HCl-loaded PLGA seeds using PLGA of different viscosities 30 wt % IRN HCl-loaded PLGA seeds with a diameter of 2 mm and a length of 6 mm were prepared according to Example 2, substituting either "5002" or "5010" PLGA for "5004" PLGA.
[0135] Example 5: Content uniformity and drug stability of IRN HCl-loaded PLGA seeds Random samples (n=10) of each seed type were selected, weighed, and placed in glass vials. DCM (10 mL) was added to each vial and allowed to sit for 1 hour to allow the seeds to dissolve. Once dissolved, the vials were placed in a water bath set at 40°C to allow complete evaporation of the dichloromethane. The remaining residue was resuspended in HPLC mobile phase to disrupt the PLGA polymer and allow the IRN HCl to go into solution. The solution was sonicated for 30 minutes to ensure complete dissolution of the IRN HCl. The solution was then filtered and analyzed for its IRN HCl concentration using the HPLC method described below.
[0136] Figures 3 and 4 show that the drug content of the tested seeds was 98%-104% of the theoretical value, confirming that the hot melt extrusion process produced seeds with the desired drug content.
[0137] Figure 5 shows the variation in drug content of 30% w / w seeds prepared according to Examples 3(A)–(E). Mixing at 100 RPM and 150°C requires 0% w / w plasticizer to ensure uniform mixing of IRN into PLGA. Because it may be desirable to produce seeds without the need for plasticizer, alternative hot-melt extrusion parameters were investigated, as detailed in Example 3. Removing the plasticizer significantly reduced the average IRN content in the seeds, and uniformity was poor, with a standard deviation of 25.6 (Figure 5B). To increase residence time and improve mixing, the screw speed was reduced to 90 RPM, but the average drug content further decreased due to IRN degradation (Figure 5C). By reducing the mixing temperature to 130°C and maintaining the screw speed at 90 RPM, acceptable IRN content and uniformity (Figure 5E, standard deviation of 1.8) were achieved, similar to seeds containing 10% plasticizer.
[0138] Raman spectroscopic mapping (FIG. 6) performed on cross-sections of the seeds from Example 3 confirmed that the drug was uniformly distributed throughout the seeds in Examples 3(A) and 3(E). In Examples 3(B), (C), and (D), the drug was not uniformly distributed throughout the seeds, with the overall intensity of the dark spots being low, indicating low drug content. IRN HPLC Method: HPLC analysis was performed on a Dionex Ultimate 3000 HPLC equipped with a Phenomenex Luna C18 4.6 x 150 mm column with 5 μm particle size. The mobile phase consisted of 75% pH 2.7 phosphate buffer and 25% acetonitrile. The flow rate was 1.00 mL / min, and UV detection was performed at a wavelength of 225 nm with an injection volume of 20 μL. Linearity was observed in the range of 0.01 to 10 mg / mL, with an R 2 was 1.00.
[0139] Example 6A: Preparation of multi-layered seeds loaded with IRN-HCl (30% w / w) and PVT (50% w / w) 3 g of IRN HCl was mixed with 7 g of "5004" PLGA to obtain mixture A. 5 g of PVT was separately mixed with 5 g of "5004" PLGA to obtain mixture B.
[0140] Mixture A was fed into the barrel of a hot-melt extruder. The feed rate was set at 4.5 g / min, and the extruder screw speed was set at 90 RPM. The hot-melt extruder barrel had three heating zones: Heating Zone 1 (feed zone) was set at 45 °C, Heating Zone 2 (mixing zone) was set at 130 °C, and Heating Zone 3 (discharge zone) was set at 70 °C. The extruder torque ranged from 4 to 8 N·m, depending on the composition of the mixture fed into the extruder. The extruder die was 4 mm, and the discharge conveyor was set at 150 RPM to maintain an extrudate diameter of 2 mm. Once solidified, the extrudate was cut into (A) 3 mm long seeds. The above hot-melt extrusion process was repeated with Mixture B to obtain (B) 3 mm long seeds.
[0141] Two-layered implants were fabricated by butt-welding (A) seed to (B) seed as follows: a pellet knife was heated to 120°C, and (A) seed and (B) seed were pressed against opposite sides of the knife. The knife was removed, and the molten edges of each layer were pressed together and held for 60 seconds to cool the polymer and fuse the layers together. The dimensions of the two-layered seed were 2 mm diameter x 6 mm length.
[0142] Example 6B: Preparation of multi-layered seeds loaded with IRN-HCl (40% w / w) and PVT (50% w / w) 4 g of IRN HCl was mixed with 6 g of "5004" PLGA to obtain mixture A. 5 g of PVT was separately mixed with 5 g of "5004" PLGA to obtain mixture B. Bilayer implants were prepared from these mixtures in a manner similar to that described for Example 6A.
[0143] Example 7: Preparation of seeds loaded with 10%, 30% or 50% w / w IRN-HCl by (A) hot melt extrusion and (B) compression A 10 wt% mixture was prepared by mixing 1 g of IRN HCl with 9 g of "5004" PLGA. A 30 wt% mixture was prepared by mixing 3 g of IRN HCl with 7 g of "5004" PLGA. A 50 wt% mixture was prepared by mixing 5 g of IRN HCl with 5 g of "5004" PLGA. A) Hot Melt Extrusion Each of the three mixtures was individually fed into the barrel of a hot-melt extruder. For all mixtures, the feed rate was set at 4.5 g / min, and the extruder screw speed was set at 90 RPM. The hot-melt extruder barrel had three heating zones: Heating Zone 1 (feed zone) was set at 45 °C, Heating Zone 2 (mixing zone) was set at 130 °C, and Heating Zone 3 (discharge zone) was set at 70 °C. The extruder torque ranged from 4 to 8 N·m, depending on the composition of the mixture fed into the extruder. The extruder die was 4 mm, and the discharge conveyor was set at 150 RPM to maintain an extrudate diameter of 2 mm. Once solidified, the extrudate was cut into 6 mm-long seeds. B) Compression Each of the three mixtures was individually fed into a 2 mm diameter pellet die and then placed in a 15 ton hydraulic KBr press. The mixtures were compressed at room temperature for 5 minutes under a pressure of 7.5 tons (116.67 PSI). The compressed implants were cut into 6 mm long seeds.
[0144] Example 8: Determination of the cytotoxicity of irinotecan in PLGA seeds against GBM cells 400 μL of the IRN-containing solution from Example 5 was diluted with 3600 μL of sterile cell culture medium and filtered. A control solution was generated by dissolving the required amount of IRN (based on the actual content of IRN in each seed) in 3 mL of DCM and then evaporating. The remaining IRN was dissolved in 3 mL of PBS, and 400 μL of this solution was diluted with 3600 μL of cell culture medium and filtered. The cytotoxicity of the solution was measured against primary GBM cell lines using a 5-day exposure time.
[0145] 7 and 8 show GBM cell viability data generated according to Example 8, demonstrating that IRN extracted from various seeds retained its cytotoxicity. There was no significant difference (P=0.562) in cell viability across samples compared to untreated control solutions at the same concentrations.
[0146] Example 9: In vitro release of IRN from PLGA seeds into both sink conditions and biorelevant release media Individual seeds (n = 4) of 2 x 3 mm dimensions with various IRN HCl loads (10, 20, 30, 40, and 50% w / w) and 30% w / w IRN HCl-loaded seeds with various lengths (2, 3, and 6 mm) were placed in sealed flasks containing either 3 mL of water (biorelevant medium) or 5 mL of phosphate buffer (pH 7.4) solution (sink-conditioning medium) and placed in an orbital shaking incubator (Unitron HT infors) at 37 °C and 60 rpm. Complete medium changes were performed on days 1, 2, 3, 4, and 7. Samples were filtered using a 0.45 μm filter and analyzed for IRN content using the HPLC method for IRN described above.
[0147] Figures 9 and 10 show in vitro release profiles measured under both sink (A) and biorelevant (B) conditions. All samples showed an "initial burst" release over the first 24 hours, followed by a prolonged, slower release up to day 7. Burst release was proportional to both the IRN HCl loading and seed length. Under sink conditions, a significant increase in drug loading from 10% to 50% (P = 0.0103) increased day 1 release from 1.2 mg to 6.8 mg, and total release over 7 days increased from 1.9 mg to 10.9 mg (P = 0.0111). However, under biorelevant conditions, there was no significant difference in release (P = 0.582) between 40 and 50% w / w seeds. This is potentially due to the large amount of IRN released onto and within the seed surface, saturating the diffusion layer at the seed / release medium interface. A significant increase in drug loading from 10 to 40 / 50% ( P = 0.0213) increased day 1 release from 1.0 mg to approximately 4.0 mg, and total release over 7 days increased from 1.8 mg to approximately 8 mg ( P = 0.0237) ( Figure 9B ).
[0148] Increasing the seed dimensions from 2 × 2 mm to 2 × 3 mm did not significantly affect drug release (Figure 10). However, increasing the dimensions to 2 × 6 mm significantly increased release, from 2.6 mg to 5.2 mg on day 1 and from 2.9 mg to 8.4 mg total release under sink conditions (Figure 10A), and from 2.3 mg to 4.0 mg on day 1 and from 3.2 mg to 7.3 mg total release under biorelevant conditions (Figure 10B).
[0149] These results demonstrate that IRN release can be controlled by both the drug loading and seed size, facilitating precise control of IRN levels in vivo. Under sink conditions, all seed formulations released over 92% of the drug loading over 7 days of release. Under biorelevant release conditions, the seed formulations released 71–102% of the drug loading over 7 days of release.
[0150] The IRN levels released into the biorelevant medium were lower than those released under sink conditions. The increased drug release under sink conditions may be due to the increased volume of the medium (5 mL compared to 3 mL) rather than its composition. It is hypothesized that the increased volume reduces the thickness and concentration of the IRN diffusion layer at the seed / release medium interface, resulting in increased drug release.
[0151] This type of release profile (an initial burst in the first 24 hours, followed by a prolonged release over 7 days) is believed to be clinically advantageous in the treatment of resected brain tumors, because the burst initially delivers a localized high dose of IRN HCl, facilitating diffusion of IRN HCl through the brain tissue and allowing it to kill most of the remaining tumor cells, while the prolonged release provides a "top-up" of IRN HCl to kill tumor cells that were in the G1 or G2 phase of the cell cycle.
[0152] The in vitro daily release profiles of seeds released under biorelevant conditions are shown in Figure 11A and B, which also illustrate the drug release profile. There was a large burst on day 1, which significantly increased with increasing drug loading (P = 0.0213). The seeds then displayed a typical matrix release profile, with drug release decreasing over time. The 2 x 3 mm 30%, 40%, and 50% w / w and 2 x 6 mm 30% w / w seed formulations were able to release at least 300–1000 μg of IRN per day for a full 7 days (represented by the upper and lower dotted lines in Figure 11A and B). Therefore, with regard to the drug release profile, the preferred drug loading is 30%–50% w / w, and the preferred seed size is 2 x 3 mm or 2 x 6 mm.
[0153] 30% w / w IRN HCl PLGA seeds prepared according to Example 4 were also evaluated for in vitro drug release profiles under sink conditions (Figure 12). The three different PLGA viscosity formulations showed the same overall profile (initial burst followed by sustained release over 7 days), but surprisingly, the "5002" seeds released significantly less drug than the "5004" or "5010" seeds. This is hypothesized to be a result of the "5004" and "5010" PLGA samples being ester-terminated, whereas the "5002" PLGA is acid-terminated. Because the parent drug in the IRN HCl salt is positively charged, interactions between the polymer acid groups and the drug may have a stabilizing effect that delays the release of the drug into aqueous dissolution media.
[0154] Example 10: Measurement of GBM cell cytotoxicity of irinotecan released from PLGA seeds under biorelevant conditions 1 mL samples of the biorelevant release media from day 1 and day 7 of the drug release experiment in Example 9 were evaluated for cytotoxicity against primary GBM cells. 400 μl of each biorelevant release sample was added to 3600 μl of cell culture medium and filtered using a syringe filter to ensure sterility. 200 μl was then added to wells of a 96-well plate containing cultured primary GBM cells and 200 μl of cell culture medium. After 5 days of exposure, an MTT assay was performed to assess cell viability.
[0155] Increasing the IRN loading from 10 to 50% w / w decreased cell viability from 21.3 to 11.2% (Figure 13, day 1 release), and increasing the seed length from 2 to 6 mm decreased cell viability from 34.0 to 25.4% (Figure 14, day 7 release). For all seeds, cell viability at day 7 was higher than that observed at day 1, which is expected due to the lower amount of IRN released at day 7 (see Figures 11A and B). These experiments demonstrate that the drug retains its cytotoxicity during formulation, storage, and release.
[0156] Samples from the release experiment using the seeds of Example 4 (Figure 15) show that the PLGA "5002" sample is ineffective at killing GBM cells on either day 1 or day 7, which is not surprising given the low drug release profile seen for "5002" in Figure 12. On the other hand, PLGA "5010" releases a significant amount of IRN HCl on day 1 (see Figure 12), but by day 7, drug release is nearly exhausted, resulting in "5010" releasing less IRN HCl than "5004" on day 7. The optimal drug release profile over 7 days was exhibited by the "5004" seeds, resulting in cell viability of less than 30% for both day 1 and day 7 release. For this reason, the preferred PLGA is an ester-endcapped 50:50 lactide:glycolide PLGA with an intrinsic viscosity of 0.32-0.48 dL / g ("5004" PLGA).
[0157] Example 11: Ex vivo testing of 2x3mm seeds on primary GBM cells harvested from surgical margins of GBM patients GBM cells were extracted from tissue harvested from the surgical margins of GBM patients, cultured, and seeded into 6-well plates. To mimic a clinical scenario, steam-sterilized 3-mm-long PLGA seeds were placed directly on the GBM cells. 3 mL of culture medium was used to cover the implants. To represent cerebrospinal fluid turnover and removal of IRN by diffusion, metabolic excretion, and infiltration into the nearby vasculature, the culture medium was changed daily, resulting in a decrease in IRN concentrations at the surgical margins. The study was designed so that the MTT assay could be performed on the cells on days 1, 2, 3, 4, 5, and 7.
[0158] Figure 16 shows that all seed implants tested reduced tumor cell viability, with the reduction in cell viability proportional to the amount of IRN HCl loaded in the seeds. 10 and 20 wt% IRN HCl seeds reduced cell viability to 49.3% and 32.1%, respectively, by day 4, but significant cell regrowth (recurrence) occurred on days 5 and 7. 30 wt% IRN HCl seeds reduced cell viability to 0% by day 5, while 40 and 50 wt% IRN HCl seeds achieved this by day 4. Furthermore, there was no sign of cell regrowth (recurrence) in the 30, 40, and 50 wt% seeds, suggesting that all of the GBM cells had been killed.
[0159] These results indicate that 30 wt%, 40 wt%, and 50 wt% seeds deliver sufficient irinotecan over a 7-day period to completely kill all residual tumor cells remaining after surgical resection.
[0160] Example 12: In vivo evaluation of the toxicity of 30, 40 and 50% w / w seeds in sham resection cavities of tumor-free mice To assess their toxicity, 2x2mm seed formulations loaded with 0, 30, 40, and 50% w / w IRN were implanted into the sham resection cavities of tumor-free, immunocompetent C57 / BL6 mice. Mice were sacrificed by transcardial perfusion at 7, 14, 28, and 56 days post-implantation. Brains were preserved in 10% formalin at harvest and transferred to 2.5% formalin 24 hours later. Brains were cut coronally at the rostral and caudal ends of the resection cavity and then embedded in paraffin blocks. Blocks were cut into 4µm-thick slices and stained with H&E. The resulting histological slides (Figure 17) were examined by a blinded clinical pathologist. The degree of acute inflammation, chronic inflammation, macrophage infiltration, and necrosis were scored individually on a scale of 0 to 2 (low, moderate, high) and summed to obtain a "toxicity score" for each seed formulation at each time point (Figure 18). In vivo toxicity studies conform to the NIH Guide for the Care and Use of Laboratory Animals.
[0161] The toxicity results shown in Figure 18 elucidate the toxicity profile of the seeds compared to the placebo control. Regardless of the IRN loading dose, a moderate level of acute inflammation is observed one week after implantation, but this inflammation subsides over time. This behavior is attributed to the wound healing response to the resection-induced surgical brain injury. Similarly, chronic inflammation due to sustained drug release from the seeds is highest at the beginning of implantation as a result of an initial burst of IRN from the seeds and typically resolves over time, although 40% still has detectable levels at 56 days. While only mild chronic inflammation is observed in the 0% and 30% groups, both the 40% and 50% groups show moderate inflammation at 14 days, implying that these higher concentrations of IRN induce a stronger inflammatory response. This observation is further supported by the presence of necrosis in both the 40% and 50% groups. In summary, 30% seeds do not appear to be substantially more toxic than placebo controls, whereas 40% and 50% seeds cause increased immune activity and transient damage to parenchymal tissue.
[0162] Example 13: In vivo testing of 30, 40 and 50% w / w seeds in a GBM mouse resection model The U-87MG human GBM cell line is characterized as a glial tumor with the histopathological appearance of GBM. The cell line was obtained from ATCC (Manassas, Virginia, USA). The GBM cell line was maintained in culture in DMEM medium at 37°C in a 5% CO2 incubator. Flasks were kept in logarithmic growth phase, and cells were passaged every 3–4 days.
[0163] Orthotopic GBM tumors were established in the brains of immunodeficient athymic nude mice (n = 5 per group) by stereotactic injection as previously described
[16] . Briefly, 1 × 10 tumors were injected into the brains of immunodeficient athymic nude mice (n = 5 per group) in 3 μl of serum-free DMEM. 5U87 mCherry-Fluc (U87 mChFl) cells were loaded into a 10 μl Hamilton syringe. The needle was positioned at stereotaxic coordinates [3.0, -0.5, -1.0] from the bregma point. Tumor cells were then injected at 1 μl / min, allowed to rest for 5 minutes, and the needle was then retracted at 0.5 mm / min. Tumors were allowed to engraft and grow for 1 week. Established tumors were then resected under fluorescence guidance, and 2 × 2 mm seeds loaded with 30, 40, and 50 wt% IRN HCl were implanted into the resulting resection cavity (Figure 19). Mouse survival was monitored for 70 days, and Kaplan-Meier survival curves were generated (Figure 20). Changes in tumor volume were tracked by bioluminescence. Mice were injected with 150 mg / kg luciferin IP and imaged 10 minutes later under isoflurane anesthesia using an IVIS kinetic imager. Identical sized regions of interest were drawn on the head of each mouse and the mean radiance was recorded (Figure 21, image of a surviving mouse 70 days post-implantation). In vivo efficacy studies conformed to the NIH Guide for Care and Use of Laboratory Animals.
[0164] Efficacy data (Figure 20) show that 100% of mice in the sham (no implant) and placebo groups died by days 27 and 31, respectively. However, 100% of mice in the 50% wt implant group died by day 22, which is consistent with the toxicity levels observed in toxicity studies for this drug load (Example 12). Mice in the 30% wt and 40% wt implant groups demonstrated long-term survival, with 40% still alive at day 70. Furthermore, surviving mice did not exhibit the expected symptoms associated with brain tumor recurrence, and none of the mice showed signs of brain fluorescence, indicative of tumor recurrence, when imaged using Fluc bioluminescence imaging (Figure 21). In vivo studies indicate that the preferred drug loads for balancing tumor cytotoxicity and systemic toxicity are 30% wt and 40% wt IRN drug loads.
[0165] Example 14: In vitro release of IRN from PLGA seeds prepared by HME and compression Seeds loaded with 10%, 30% and 50% w / w IRN HCl were produced by both hot melt extrusion (HME) as described in Example 7.
[0166] Individual seeds were placed in a sealed flask containing 5 mL of phosphate buffer (pH 7.4) solution (sink condition medium) and placed in an orbital shaking incubator (Unitron HT infors) at 37°C and 60 rpm. Complete medium changes were performed on days 1, 2, 3, 4, and 7. Samples were filtered using a 0.45 μm filter and analyzed for IRN content using the HPLC method for irinotecan described above.
[0167] Figure 22 shows the measured in vitro release profiles. Seeds produced by compression (Figures 22A and C) delivered a very large "initial burst" of IRN over the first 24 hours, with almost all of the IRN released by day 4, and very limited IRN release from days 4 to 7 (Figure 22C). Seeds produced by HME (Figures 22B and D) delivered an "initial burst" release over the first 24 hours, followed by a prolonged, slower release until day 7. 30% and 50% w / w HME seeds were able to release at least 500-1000 μg of IRN per day for the full 7 days (represented by the lower and upper dotted lines in Figure 22D), demonstrating a range of efficacy consistent with the therapeutic window desired for the treatment of gliomas. In this regard, HME is superior to compression in delivering IRN-loaded seeds with desirable properties for the treatment of solid tumors.
[0168] Example 15: Determination of the cytotoxicity of IRN, temozolomide (TMZ), and the combination of IRN with pitavastatin (PVT) on GBM cells TMZ, IRN, and IRN+PVT were added at increasing concentrations up to 5 log nm to primary GBM cultures from eight patients with recurrent GBM. After 5 days of exposure, an MTT assay was performed to assess cell viability.
[0169] Figure 23 shows the cytotoxicity of the three treatments. All eight patient cell lines evaluated did not significantly respond to TMZ treatment. Six of the eight patient cell lines responded to treatment with IRN, and all eight patient cell lines responded to treatment with IRN + PVT. In the combination group, at a concentration of 5 log nm of both IRN and PVT, there were no viable GBM cells in six of the eight patient lines.
[0170] In a separate experiment, 5 log nm of TMZ, 3.5 log nm of IRN, or 2.5 log nm of IRN + PVT (exposure concentrations used were based on the mean IC50 values determined from Figure 23; temozolomide did not achieve an IC50, so 5.0 log nM was used) were added to primary GBM cultures harvested from four recurrent GBM patients. After 3, 5, 7, 9, and 11 days of exposure, mean cell viability was assessed by MTT assay.
[0171] Figure 24 shows the cytotoxicity of the three treatments over different exposure times. In all three treatment groups for all four patient cell lines, cell viability was lowest after 3 days, with viability increasing over 11 days. Cell viability in the TMZ arm was 160-200%, while in the IRN-alone arm, cell viability was 80-120%. However, in the IRN+PVT group, cell viability at day 11 was 60-80%. This data suggests that the IRN+PVT combination is superior in delaying recurrence compared to TMZ or IRN alone.
[0172] Example 16: In vitro release of IRN and PVT from bilayered PLGA seeds Bilayer seeds loaded with IRN-HCl (30% w / w) and PVT (50% w / w) were prepared according to Example 6A, and bilayer seeds loaded with IRN-HCl (40% w / w) and PVT (50% w / w) were prepared according to Example 6B.
[0173] Individual seeds were placed in a sealed flask containing 5 mL of phosphate buffer (pH 7.4) solution (sink condition medium) and placed in an orbital shaking incubator (Unitron HT infors) at 37°C and 60 rpm. Complete medium changes were performed daily for 14 days. Samples were filtered using a 0.45 μm filter and analyzed for IRN and PVT content over 14 days using the irinotecan HPLC method described above.
[0174] Figure 25 shows the in vitro release profiles, measured as both daily (Figures 25A and 25B) and cumulative (Figures 25C and 25D) API release. The bilayer seeds provided an initial burst of both IRN and PVT over the first 2-4 days, followed by sustained release of the APIs for up to 14 days. The dashed lines in Figures 25A and 25B represent the potential daily amounts of IRN and PVT (0.16 mg and 0.22 mg, respectively) that would need to be released to be effective based on the cytotoxicity data from Example 15 (Figures 23 and 24). Both seeds (30:50% w / w and 40:50% w / w IRN:PVT) were observed to continuously release at least these amounts of both APIs for at least 12 days.
[0175] Example 17: Ex vivo testing of bilayered PLGA seeds loaded with IRN and PVT on primary GBM cells harvested from surgical margins of GBM patients GBM cells were extracted from tissue harvested from the surgical margins of patients with recurrent GBM, cultured, and seeded into 6-well plates. To mimic a clinical scenario, steam-sterilized seeds ((A) 2 mm × 6 mm PLGA seeds without added API—control; (B) bilayered seeds loaded with IRN-HCl (30% w / w) and PVT (50% w / w) prepared according to Example 6A; (C) bilayered seeds loaded with IRN-HCl (40% w / w) and PVT (50% w / w) prepared according to Example 6B) were placed directly on the GBM cells. 3 mL of media was used to cover the implants. To represent cerebrospinal fluid turnover and removal of API by diffusion, metabolic excretion, and penetration into the nearby vasculature, media was changed daily, thereby reducing the concentration of API at the surgical margins. This study was designed so that the MTT assay could be performed on the cells on days 1, 2, 3, 4, 5, and 7.
[0176] Figure 26 shows that both seed implants tested significantly reduced tumor cell viability compared to control seed implants. Both bilayered IRN / PVT seed implants exhibited similar ex vivo GBM cell cytotoxicity, with negligible cell survival observed after 4 days of incubation. There was no sign of cell regrowth (recurrence) up to 7 days after implantation, suggesting that all GBM cells were killed by the combined IRN and PVT seed implants.
[0177] (References) [1] Dolecek et al., Neuro. Oncol.(2012), 14, Suppl 5:v1-49. [2] Ostrom et al., Neuro. Oncol.(2013), 15, 1-56. [3] Thakkar et al., Cancer Epidemiol. Biomarkers Prev.(2014), 23, 1985-1996. [4] Stupp et al. New Engl. J. Med.,(2005), 10, 987-96. [5] Ostrom et al., Neuro. Oncol.(2014), 16, 896-913. [6] Wang et al., Adv. Drug Deliv. Rev.(2002), 54, 987-1013. [7] Westphal et al., Neuro. Oncol.(2003), 5, 79-88. [8] Ramachandran et al., Sci Rep.(2017), 7, 43271. [9] McConville et al., Int. J. Pharm.(2015) 494(1), 73-82.
[10] Lesniak et al., Anticancer Res.(2005) 25, 3825-3831.
[11] Zembeko et al., J. Pharm. Sci.(2015) 104(3), 1076-86.
[12] Xu, Ann. Oncol.(2002) 13, 1841-1851;Sinha, Drugs.(1995), 49, 11-19;Vrendenburgh et al., Neuro. Oncol.(2009) 11, 80-91.
[13] Vrendenburgh et al., Neuro. Oncol.(2009) 11, 80-91.
[14] Baltes et al., J. Mater. Sci : Mater. Med.(2010), 21, 1393-1402.
[15] Cruickshank et al., Neuro. Oncol.(2015), 17, 11 [Clinical Trial Identifier: NCT02433392].
[16] Shah et al., J. Neurosci.(2008), 28, 4406-4413;van Eekelen et al., Oncogene(2010), 29, 3185-3195. The present application also includes the following aspects. [Aspect 1] A chemotherapy seed comprising a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; the seed having a first length of at least 0.5 mm. [Aspect 2] The seed of embodiment 1, wherein the biodegradable polymer is a lactic acid-co-glycolic acid or polylactic acid. [Aspect 3] 2. The seed of embodiment 1, wherein the biodegradable polymer is a lactic acid-co-glycolic acid copolymer end-capped with ester groups. [Aspect 4] Aspect 4. The seed of any one of aspects 1 to 3, wherein the biodegradable polymer has an acid value of 1 mg KOH / g or less. [Aspect 5] 5. The seed of any one of aspects 2-4, wherein the lactic acid-glycolic acid copolymer has a weight ratio of lactic acid:glycolic acid of about 5:95, about 15:85, about 25:75, about 40:60, about 50:50, about 60:40, about 75:25, about 85:15, or about 95:5. [Aspect 6] 6. The seed of any one of aspects 2 to 5, wherein the lactic acid-glycolic acid copolymer has an intrinsic viscosity of 0.15 to 1.2 dL / g when measured at 25°C in chloroform at a concentration of 0.5 g / dL. [Aspect 7] Aspect 7. The seed of any one of aspects 1 to 6, wherein the drug is present in a loading amount of 1 to 50% by weight based on the weight of the seed. [Aspect 8] The seed of embodiment 7, wherein the drug is present in a loading amount of 25-45% by weight based on the weight of the seed. [Aspect 9] A seed according to any one of aspects 1 to 8, wherein the drug is a pharmaceutically acceptable salt of irinotecan. [Aspect 10] The seed according to embodiment 9, wherein the drug is irinotecan hydrochloride. [Aspect 11] 11. The seed of any one of aspects 1 to 10, wherein the seed has a first length of 1 to 4 mm. [Aspect 12] 12. The seed of any one of aspects 1-11, wherein the seed has a second length of 2-6 mm. [Aspect 13] 13. The seed of embodiment 12, wherein the seed is substantially cylindrical, the first length is a seed diameter, and the second length is a seed length. [Aspect 14] 14. The seed of embodiment 13, wherein the seed has a first length of about 2 mm and a second length of about 3 mm or about 6 mm. [Aspect 15] 15. The seed of any one of aspects 1-14, wherein the seed further comprises a pharmaceutically acceptable plasticizer. [Aspect 16] 16. The seed according to embodiment 15, wherein the plasticizer is selected from poloxamer, polyethylene glycol, polyvinyl acetate, and macroglycerol hydroxystearate. [Aspect 17] Aspect 15. The seed of any one of aspects 1 to 14, wherein the seed does not contain a plasticizer. [Aspect 18] A chemotherapy seed comprising a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; the seed having a first length of at least 0.5 mm. [Aspect 19] 19. The seed of any one of aspects 1-18, wherein the seed releases the drug continuously for at least 3 days, at least 4 days, at least 5 days, at least 6 days, or at least 7 days when placed in an aqueous physiological environment. [Aspect 20] When the seeds are placed in an aqueous physiological environment, the total amount of drug released is: i. More than 20% of the drug after 1 day; ii. More than 30% of the drug after 3 days; iii. More than 40% of the drug after 5 days; and / or iv. More than 50% of the drug after 7 days 20. The seed according to any one of embodiments 1 to 19, wherein the seed releases [Aspect 21] 21. The seed of any one of aspects 1 to 20, wherein the seed releases at least 300-1000 μg of drug per day for at least 5 days, at least 6 days, or at least 7 days when placed in an aqueous physiological environment. [Aspect 22] 22. The seed of any one of aspects 1-21, wherein the seed further comprises one or more additional therapeutic agents selected from an anti-cancer agent (e.g., bevacizumab), a statin (e.g., pitavastatin), an antiplatelet agent (e.g., ticlopidine), an anti-fungal agent (e.g., itraconazole), an angiotensin-converting enzyme (ACE) inhibitor (e.g., captopril), an inhibitor of the enzyme acetaldehyde dehydrogenase (e.g., disulfiram), an anti-inflammatory agent (e.g., celecoxib), and copper gluconate. [Aspect 23] 23. The seed of embodiment 22, wherein the seed comprises two layers, a first layer comprising a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, a derivative of irinotecan, and a pharmaceutically acceptable salt of a derivative of irinotecan; and a second layer comprising a biodegradable polymer and an additional therapeutic agent (e.g., pitavastatin). [Aspect 24] A pharmaceutical composition comprising one or more seeds according to any one of aspects 1 to 23. [Aspect 25] A seed according to any one of aspects 1 to 23 or a pharmaceutical composition according to aspect 24 for use in therapy. [Aspect 26] A seed according to any one of aspects 1 to 23 or a pharmaceutical composition according to aspect 24 for use in the treatment of brain tumors. [Aspect 27] The following process: a) feeding a drug and a biodegradable polymer into a hot melt extruder; b) extruding the mixture through an extruder; c) forming the extrudate of step b) into one or more seeds of required dimensions 24. A method for producing a chemotherapy seed according to any one of aspects 1 to 23, comprising:
Claims
1. 1. A chemotherapy seed comprising a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, 7-ethyl-10-hydroxy-camptothecin (SN-38), and a pharmaceutically acceptable salt of SN-38, the seeds have a first length of about 2 mm and a second length of about 3 mm to about 6 mm; The seed is substantially cylindrical, the first length is a seed diameter, and the second length is a seed length. The seed.
2. The seed of claim 1 , wherein the biodegradable polymer is a lactic acid-glycolic acid copolymer or polylactic acid.
3. The seed of claim 1 , wherein the biodegradable polymer is a lactic acid-glycolic acid copolymer end-capped with ester groups.
4. The seed according to any one of claims 1 to 3, wherein the biodegradable polymer has an acid value of 1 mgKOH / g or less.
5. 5. The seed of claim 2, wherein the lactic acid-glycolic acid copolymer has a weight ratio of lactic acid:glycolic acid of about 5:95, about 15:85, about 25:75, about 40:60, about 50:50, about 60:40, about 75:25, about 85:15, or about 95:
5.
6. The seed according to any one of claims 2 to 5, wherein the lactic acid-glycolic acid copolymer has an intrinsic viscosity of 0.15 to 1.2 dL / g when measured in chloroform at a concentration of 0.5 g / dL at 25°C.
7. 7. The seed of any one of claims 1 to 6, wherein the drug is present in a loading amount of 1 to 50% by weight based on the weight of the seed.
8. 8. The seed of claim 7, wherein the drug is present in a loading amount of 25 to 45% by weight based on the weight of the seed.
9. The seed according to any one of claims 1 to 8, wherein the drug is a pharmaceutically acceptable salt of irinotecan.
10. The seed according to claim 9, wherein the drug is irinotecan hydrochloride.
11. The seed of any one of claims 1 to 10, wherein the seed has a second length of about 3 mm or about 6 mm.
12. The seed according to any one of claims 1 to 11, wherein the seed further comprises a pharmaceutically acceptable plasticizer.
13. 13. The seed of claim 12, wherein the plasticizer is selected from poloxamer, polyethylene glycol, polyvinyl acetate, and macroglycerol hydroxystearate.
14. The seed according to any one of claims 1 to 11, wherein the seed does not contain a plasticizer.
15. 1. A chemotherapy seed comprising a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, 7-ethyl-10-hydroxy-camptothecin (SN-38), and a pharmaceutically acceptable salt of SN-38, the seeds have a first length of about 2 mm and a second length of about 3 mm to about 6 mm; The seed is substantially cylindrical, the first length is a seed diameter, and the second length is a seed length. The seed.
16. 16. The seed of any one of claims 1 to 15, wherein the seed releases the drug continuously for at least 3 days, at least 4 days, at least 5 days, at least 6 days, or at least 7 days when placed in an aqueous physiological environment.
17. When the seeds are placed in an aqueous physiological environment, the total amount of drug released is: i. More than 20% of the drug after 1 day; ii. More than 30% of the drug after 3 days; iii. More than 40% of the drug after 5 days; and / or iv. More than 50% of the drug after 7 days The seed according to any one of claims 1 to 16, which releases
18. 18. The seed of any one of claims 1 to 17, wherein the seed releases at least 300 to 1000 μg of drug per day for at least 5 days, at least 6 days, or at least 7 days when placed in an aqueous physiological environment.
19. 19. The seed of any one of claims 1 to 18, wherein the seed further comprises one or more additional therapeutic agents selected from anti-cancer agents, statins, anti-platelet agents, anti-fungal agents, angiotensin converting enzyme (ACE) inhibitors, inhibitors of the enzyme acetaldehyde dehydrogenase, anti-inflammatory agents, and copper gluconate.
20. The seed comprises two layers, the first layer comprises a biodegradable polymer and a drug selected from irinotecan, a pharmaceutically acceptable salt of irinotecan, 7-ethyl-10-hydroxy-camptothecin (SN-38), and a pharmaceutically acceptable salt of SN-38; and the second layer comprises a biodegradable polymer and an additional therapeutic agent; 20. The seed of claim 19.
21. A seed described in claim 19 or 20, wherein the further therapeutic agent is pitavastatin.
22. A pharmaceutical composition comprising one or more seeds according to any one of claims 1 to 21.
23. A seed according to any one of claims 1 to 21 or a pharmaceutical composition according to claim 22 for use in therapy.
24. A seed according to any one of claims 1 to 21 or a pharmaceutical composition according to claim 22 for use in the treatment of brain tumors.
25. The following steps: a) feeding a drug and a biodegradable polymer into a hot melt extruder; b) extruding the mixture through an extruder; c) forming the extrudate of step b) into one or more seeds of required dimensions A method for producing a chemotherapy seed according to any one of claims 1 to 21, comprising:
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