OVERCOMING THE PROTECTIVE BARRIERS OF BREAST CANCER IN BONE MARROW WITH TARGETED PRODRUG NANOTHERAPY

通过靶向前药纳米疗法克服骨髓中乳腺癌的保护性屏障

• 批准号: 10320444
• 负责人: Gregory M Lanza
• 金额: $ 61.05万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-01-12 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10320444
• 关键词: Address; Adjuvant; Biological Availability; Biology; Biopsy; Bone Marrow; Bone Pain; Bone neoplasms; Breast; Breast Cancer Patient; Breast Cancer Risk Factor; Breast Cancer Treatment; Breast cancer metastasis; Camptothecin; Cancer Biology; Cancer Model; Cancer Relapse; Cells; Chemoprotective Agent; Chemoresistance; Clinical; Data; Dependence; Development; Disease; Doctor of Philosophy; Dose; Drug Delivery Systems; Effectiveness; Goals; Hematology; Hepatic; Heterozygote; Human; ITGB3 gene; Image; Implant; In Vitro; Integrin alphaVbeta3; Journals; Lipase; Malignant Bone Neoplasm; Malignant neoplasm of lung; Mammary Neoplasms; Mastectomy; Medical; Metastatic Neoplasm to the Bone; Metastatic breast cancer; Micelles; Micrometastasis; Mus; Nature; Neoadjuvant Therapy; Neoplasm Metastasis; Oncogenic; Oncologist; Oncology; Operative Surgical Procedures; Osteoclasts; Osteolytic; Pathological fracture; Patients; Pharmaceutical Preparations; Physicians; Prodrugs; Quality of life; Radiation; Recurrent disease; Relapse; Research; Resistance; Safety; Scientist; Site; Stromal Cells; Surveys; Testing; Therapeutic; Therapeutic Human Experimentation; Topoisomerase; Toxic effect; Transforming Growth Factor beta; Tumor Burden; Tumor-associated macrophages; Up-Regulation; Visceral; Visceral metastasis; Woman; anticancer research; bone; cancer recurrence; cancer stem cell; cancer subtypes; cell type; chemotherapy; clinical investigation; clinically relevant; cytotoxic; docetaxel; dosimetry; hormone therapy; hypoxia inducible factor 1; improved; in vivo; inhibitor; lifetime risk; malignant breast neoplasm; mortality; nanomedicine; nanosystems; nanotherapy; neoplastic cell; novel strategies; programs; relapse risk; response; selective expression; skeletal; spinal cord compression; stem cells; transforming growth factor beta3; treatment response; tumor; tumor progression

Women have a 1 in 8 lifetime risk of breast cancer making it their second highest oncogenic cause of mortality behind lung cancer. Thirty percent of patients with stage I to III disease have silent bone marrow (BM) micro-metastases, which increase their likelihood of cancer recurrence as well as complications, such as pathological fractures, and related to the osteolytic nature of the disease. Even patients with limited early-stage disease, who responded well to chemo- or hormonal therapy at the primary site, may relapse years later when dormant bone marrow micro-metastases, previously protected within the bone marrow niche, recrudesce. Our research has recently revealed that breast cancer metastasis in the presence of bone marrow stromal cells, in vitro and in vivo, up-regulated αvβ3-integrin expression, leading to marked diminished sensitivity to systemic chemotherapy. Moreover, these data indicated that TGF-β3 sequestered in the bone microstroma was liberated to induce αvβ3-integrin up-regulation. Utilizing this bone BC target, αvβ3-targeted mixed micelles (~15nm) incorporating Sn2 lipase-labile docetaxel (DTX) prodrug (DTX-PD) (αvβ3-DTX-PD MP) were developed to rapidly and homogeneously penetrate into the tumor shown and deliver DTX therapy directly into the cell through a novel approach, termed "Contact Facilitated Drug Delivery" (CFDD). αvβ3-DTX-PD MP markedly reduced bone marrow BC tumor burden and osteolytic damage with negligible off-target effects, whereas systemic DTX at up to 4-fold higher doses had no impact on tumor progression yet elicited hepatic and hematologic toxicity. However, many patients with bone BC likely will have previously received DTX. From this perspective and recognizing the "stem cell" nature of breast cancer bone metastases, a camptothecin (CPT) Sn2 lipase-labile prodrug (CPT-PD) was developed to offer a new patient-naive treatment. CPT is a topoisomerase 1 (TOPO 1) inhibitor with powerful hypoxia-inducible factor 1-alpha (HIF-1α) inhibitor that is cytotoxic to cancer stem cells. This proposal investigates the efficacy and safety the αvβ3-CPT-PD-MP or αvβ3-DTX-PD MP nanosystems against the bone BC tumors, micro-metastases, dormant tumor cells to provide potent therapy to bone and to reduce the risk of breast cancer relapse from micrometastases. This proposal addresses the unmet therapeutic challenge and medical need posed by BC bone metastases. This project will delineate the bone BC efficacy and safety of αvβ3-Sn2-prodrug micelles and also elucidate the impact of key bone microstroma constituents such as TGF-β and αvβ3+ tumor associated macrophages (M2 TAMS) and αvβ3+ osteoclasts on treatment responses. The translational overarching goals are to more effectively treat patients with Stage 4 breast cancer in bone (Aims 1& 2), and to increase the enduring cure rate for Stage 1 to 3 BC patients by treating occult breast cancer micro-metastases to diminish disease relapse (Aim 3).

女性一生中有八分之一患乳腺癌的风险，使其成为第二大致癌原因 死亡率仅次于肺癌。 30% 的 I 至 III 期疾病患者具有沉默骨髓 (BM) 微转移，这会增加癌症复发和并发症的可能性，例如 病理性骨折，与疾病的溶骨性质有关。即使是早期病情有限的患者 在原发部位对化疗或激素治疗反应良好的疾病可能会在数年后复发 先前受骨髓生态位保护的休眠骨髓微转移复发。 我们的研究最近表明，乳腺癌转移在骨髓基质存在的情况下 细胞在体外和体内上调 αvβ3 整合素表达，导致对 全身化疗。此外，这些数据表明 TGF-β3 隔离在骨微基质中 被释放以诱导αvβ3-整合素上调。利用这种骨BC靶标，αvβ3靶向混合胶束 (~15nm) 掺入 Sn2 脂肪酶不稳定的多西紫杉醇 (DTX) 前药 (DTX-PD) (αvβ3-DTX-PD MP) 开发用于快速均匀地渗透到所示肿瘤并将 DTX 治疗直接递送到 通过一种称为“接触促进药物递送”（CFDD）的新方法来治疗细胞。 αvβ3-DTX-PD MP 显着减少骨髓 BC 肿瘤负荷和溶骨损伤，脱靶效应可忽略不计， 而全身 DTX 在高达 4 倍的剂量下对肿瘤进展没有影响，但引起了肝损伤 和血液学毒性。 然而，许多骨 BC 患者之前可能接受过 DTX。从这个角度和 认识乳腺癌骨转移的“干细胞”性质，喜树碱 (CPT) Sn2 脂肪酶不稳定 前药（CPT-PD）的开发是为了提供一种新的未经患者治疗的治疗方法。 CPT 是一种拓扑异构酶 1 (TOPO 1) 具有强效缺氧诱导因子 1-α (HIF-1α) 抑制剂的抑制剂，对癌症干细胞具有细胞毒性。 该提案研究了 αvβ3-CPT-PD-MP 或 αvβ3-DTX-PD MP 纳米系统的功效和安全性 对抗骨 BC 肿瘤、微转移、休眠肿瘤细胞，为骨和骨提供有效的治疗 降低乳腺癌微转移复发的风险。 该提案解决了 BC 骨带来的未满足的治疗挑战和医疗需求 转移。该项目将描述 αvβ3-Sn2-前药胶束的骨 BC 功效和安全性，以及 阐明骨微基质关键成分（例如 TGF-β 和 αvβ3+）对肿瘤相关的影响 巨噬细胞 (M2 TAMS) 和 αvβ3+ 破骨细胞对治疗反应的影响。翻译的总体目标 更有效地治疗患有骨内乳腺癌 4 期的患者（目标 1 和 2），并提高 通过治疗隐匿性乳腺癌微转移来减少 1 至 3 期 BC 患者的持久治愈率 疾病复发（目标 3）。

项目成果

Radionuclides transform chemotherapeutics into phototherapeutics for precise treatment of disseminated cancer.

放射性核素将化学治疗剂转化为光疗法，以精确治疗传播癌症。

• DOI: 10.1038/s41467-017-02758-9
• 发表时间: 2018-01-18
• 期刊: Nature communications
• 影响因子: 16.6
• 作者: Kotagiri N;Cooper ML;Rettig M;Egbulefu C;Prior J;Cui G;Karmakar P;Zhou M;Yang X;Sudlow G;Marsala L;Chanswangphuwana C;Lu L;Habimana-Griffin L;Shokeen M;Xu X;Weilbaecher K;Tomasson M;Lanza G;DiPersio JF;Achilefu S
• 通讯作者: Achilefu S

Cellular Trafficking of Sn-2 Phosphatidylcholine Prodrugs Studied with Fluorescence Lifetime Imaging and Super-resolution Microscopy.

使用荧光寿命成像和超分辨率显微镜研究 Sn-2 磷脂酰胆碱前药的细胞贩运。

• DOI: 10.33218/prnano1(2).180724.1
• 发表时间: 2018
• 期刊: Precision nanomedicine
• 作者: Maji,Dolonchampa;Lu,Jin;Sarder,Pinaki;Schmieder,AnneH;Cui,Grace;Yang,Xiaoxia;Pan,Dipanjan;Lew,MatthewD;Achilefu,Samuel;Lanza,GregoryM
• 通讯作者: Lanza,GregoryM

Loss of Consciousness in a 34 Yo Male Related to Marijuana.

一名 34 岁男性因吸食大麻而失去意识。

• DOI: 10.29011/2574-7754.101468
• 发表时间: 2023
• 期刊: Annals of case reports
• 作者: Merchant,Azim;Singareddy,Aashray;McCabe,Leighton;Raghupathy,Rachana;Wang,Qianli;Hwang,Daniel;Zajarias,Alan;Lanza,GregoryM
• 通讯作者: Lanza,GregoryM

Implementation and prospective clinical validation of AI-based planning and shimming techniques in cardiac MRI.

心脏MRI中基于AI的计划和光滑技术的实施和前瞻性临床验证。

• DOI: 10.1002/mp.15327
• 发表时间: 2022-01
• 期刊: Medical physics
• 影响因子: 3.8

VLA4-Targeted Nanoparticles Hijack Cell Adhesion-Mediated Drug Resistance to Target Refractory Myeloma Cells and Prolong Survival.

• DOI: 10.1158/1078-0432.ccr-20-2839
• 发表时间: 2021-04-01
• 期刊: Clinical cancer research : an official journal of the American Association for Cancer Research
• 作者: Fontana F;Scott MJ;Allen JS;Yang X;Cui G;Pan D;Yanaba N;Fiala MA;O'Neal J;Schmieder-Atteberry AH;Ritchey J;Rettig M;Simons K;Fletcher S;Vij R;DiPersio JF;Lanza GM
• 通讯作者: Lanza GM