Polymeric micelles are one of the most promising nanocarriers due to their unique core-shell structure, which could “solubilize” hydrophobic drug molecules under aqueous condition by physical encapsulation [
34]. In addition to improve the poor solubility associated with many cancer chemotherapeutic drugs such as PTX, nanocarriers can also prolong the circulation time, achieve controlled and sustained drug release, and accumulate in the tumor sites, thereby maximizing the therapeutic index and minimizing nonspecific toxicity. There are several key factors which can affect their fates
in vivo, the magnitude and pattern of tumoral distribution of nanoparticles, including their
in vivo colloidal stability, particle size, and surface characteristics [
35]. Many nanoparticles have been investigated for their potential use in drug delivery; however, only a few such as Doxil® (Doxorubicin liposomal) and Abraxane® (Albumin-bound paclitaxel) have been approved by FDA. The particle sizes for Doxil® and Abraxane® are 150 and 130 nm, respectively. Their relatively large sizes may hinder diffusion in the extracelluar space in the tumors, and thereby serve to limit their effectiveness in the treatment of solid tumors [
36]. It has been reported that the optimal nanoparticle size for tumor penetration should be less than 100 nm [
8].
In this study, a well-defined copolymer (telodendrimer) composed of PEG, lysine and cholic acid (PEG5k-CA8) was successfully developed, which can encapsulate PTX and self-assemble to form micelles in water solution, and has been tested for targeted drug delivery in the treatment of ovarian cancer. The PEG5k-CA8 telodendrimer has shown to possess many promising features such as high drug loading capacity, relatively small particle size (20–60 nm) after drug loading, sustained drug release profile, and superior stabliliy. The azide group at the distal terminus of PEG chain provides a reactive site for the conjugation of tumor cell surface or tumor endothelial cell surface binding ligands so that tumor targeting nanoparticles can be developed. These dendrimers also can be synthesized and prepared in large amount as monodispersed populations, preventing potential batch-to-batch variance.
The three building blocks for the telodendrimer including PEG, lysine, and cholic acid are all nontoxic. Our
in vitro cytotoxicity study demonstrated that no cytotoxicity of blank PEG
5k-CA
8 NPs (up to 2 mg/ml) was observed in normal human fibroblast HFF1 cells. In contrast, the commercial vehicle for PTX, the mixture of Cremophor and ethanol (1:1), had severe cytotoxicity to HFF cells at the clinically relevant blood concentration. When PEG
5k-CA
8 NPs were loaded with PTX, they showed similar cytotoxicity to ES-2 and SKOV-3 ovarian cancer cells compared with Taxol®, suggesting that PTX can be released from the nanoparticles and achieve tumor cell killing efficacy. PTX-PEG
5k-CA
8 NPs have demonstrated better safety profiles
in vivo than Taxol® or even Abraxane®. The MTD of PTX-PEG
5k-CA
8 NPs after single dose in BALB/c mice was between 75 and 100 mg PTX/kg, 2.5 times higher than that of Taxol (30 mg/kg) [
37]. The MTD of PTX-PEG
5k-CA
8 NPs after five consecutive doses in nude mice was approximately 45 mg PTX/kg, whereas that of Taxol® and Abraxane® were reported to be 13.4 and 30 mg PTX/kg, respectively [
29].
Noninvasive NIRF optical imaging technology was used to real-time monitor the biodistrubiton and tumor accumulation of PTX-PEG
5k-CA
8 NPs after administration. Hydrophobic NIFR dye DiD was encapsulated along with PTX in PEG
5k-CA
8 NPs to visualize the fates of nanoparticles in live animals. PTX-PEG
5k-CA
8 nanoparticles post i.v. injection in SKOV3-luc ovarian cancer bearing mice have shown to have a prolonged blood circulation time, and preferentially accumulate in tumors, possibly as a result of EPR effects. Notablly, the nanoparticles distributed throughout the tumors, as observed in the confocal microscopy analysis of tumor cryosection, which meant the nanoparticles had a good tumor penetration, likely attributed in part to their relatively small sizes (around 50 nm). It has been reported that although some naoparticles with larger size such as liposomes can be delivered effectively to a solid tumor via the EPR effect, they would not be distributed sufficiently to cancer cells distant from tumor vessels [
38]. The biodistribution of PEG
5k-CA
8 NPs after i.p. injection was also investigated in orthotopic intraperitoneal metastatic SKOV3-luc ovarian cancer model. The results demonstrated that the PEG
5k-CA
8 drug carrier significantly extended the residence time of paclitaxel in the peritoneal cavity, reducing the rate and extent of drug absorption from the cavity into systemic circulation. This may result in sustained and enhanced drug exposure to the ovarian tumors localized in the peritoneal cavity. A possible explanation may be that the rapidly-growing ovarian tumor cells block the lymphatic drainage, and likely restrict PEG
5k-CA
8 NPs to the peritoneum [
39].
The anti-tumor efficacy of PTX-PEG5k-CA8 NPs was evaluated after i.v. therapy in subcutaneous ovarian cancer model and i.p. therapy in the orthotopic i.p. metastatic ovarian cancer model. PTX-PEG5k-CA8 NPs exhibited superior toxicity profiles and higher antitumor activity in both ovarian cancer models as compared with Taxol® or Abraxane® at equivalent PTX doses. There are several possible explanations for enhanced efficacy and relatively lower toxicity of PTX-PEG5k-CA8 NPs after intravenous injection. First, the PEG5k-CA8 nanocarrier may improve the pharmacokinetic profile of PTX, prolonging its circulation time, thus resulting in a higher accumulation in tumors due to EPR effects. Secondly, since PTX-PEG5k-CA8 NPs accumulate in tumor, PTX is released in a sustained manner so that tumor cells can be exposed to PTX for longer time period. Thirdly, PTX-PEG5k-CA8 NPs have a relatively smaller size (50 nm) compared to Abraxane (130 nm), which may result in deeper penetration into tumor nodules, as confirmed by confocal microscopy images. Although some uptake of the nanoparticle by the liver was observed through NIRF imaging, the culprit responsible for the nonspecific uptake is most likely the Kupffer cells in liver. There was no evidence of hepatoxicity in mice received repeated dose of PTX-PEG5k-CA8 NPs, as confirmed in both serum chemistry and histological examination.
Intraperitoneal therapy of PTX has already demonstrated survival advantages in the treatment of human ovarian cancer, but its use is limited by several complications, including infection due to prolonged use of indwelling catheter and local toxicity (e.g., abdominal pain and other gastrointestinal toxicities) [
40]. As shown in this study, the PEG
5k-CA
8 drug carrier affected the biodistribution of PTX after intraperitoneal injection and demonstrated a sustained drug release profile, resulting in enhanced efficacy and better tolerability in then peritoneally metastatic ovarian cancer mice model when compared to Taxol®.