title: Cetuximab-oxaliplatin-liposomes for epidermal growth factor receptor targeted chemotherapy of colorectal cancer.
abstract: Oxaliplatin (L-OH), a platinum derivative with good tolerability is currently combined with Cetuximab (CTX), a monoclonal antibody (mAb), for the treatment of certain (wild-type KRAS) metastatic colorectal cancer (CRC) expressing epidermal growth factor receptor (EGFR). Improvement of L-OH pharmacokinetics (PK) can be provided by its encapsulation into liposomes, allowing a more selective accumulation and delivery to the tumor. Here, we aim to associate both agents in a novel liposomal targeted therapy by linking CTX to the drug-loaded liposomes. These EGFR-targeted liposomes potentially combine the therapeutic activity and selectivity of CTX with tumor-cell delivery of L-OH in a single therapeutic approach. L-OH liposomes carrying whole CTX or CTX-Fab' fragments on their surface were designed and characterized. Their functionality was tested in vitro using four human CRC cell lines, expressing different levels of EGFR to investigate the role of CTX-EGFR interactions in the cellular binding and uptake of the nanocarriers and encapsulated drug. Next, those formulations were evaluated in vivo in a colorectal cancer xenograft model with regard to tumor drug accumulation, toxicity and therapeutic activity. In EGFR-overexpressing cell lines, intracellular drug delivery by targeted liposomes increased with receptor density reaching up to 3-fold higher levels than with non-targeted liposomes. Receptor specific uptake was demonstrated by competition with free CTX, which reduced internalization to levels similar to non-targeted liposomes. In a CRC xenograft model, drug delivery was strongly enhanced upon treatment with targeted formulations. Liposomes conjugated with monovalent CTX-Fab' fragments showed superior drug accumulation in tumor tissue (2916.0±507.84ng/g) compared to CTX liposomes (1546.02±362.41ng/g) or non-targeted liposomes (891.06±155.1ng/g). Concomitantly, CTX-Fab' targeted L-OH liposomes outperformed CTX-liposomes, which on its turn was still more efficacious than non-targeted liposomes and free drug treatment in CRC bearing mice. These results show that site-directed conjugation of monovalent CTX-Fab' provides targeted L-OH liposomes that display an increased tumor drug delivery and efficacy over a formulation with CTX and non-targeted liposomes.
authors.affiliation: Department of Pharmacy and Pharmaceutical Technology, University of Navarra, 31008 Pamplona, Spain; Laboratory Experimental Surgical Oncology, Department of Surgery, Erasmus MC Cancer Institute, Rotterdam 3015 GE, The Netherland.
authors.forename: Sara
authors.initials: S
authors.lastname: Zalba
authors.affiliation: Department of Pharmacy and Pharmaceutical Technology, University of Navarra, 31008 Pamplona, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Contreras
authors.affiliation: Laboratory Experimental Surgical Oncology, Department of Surgery, Erasmus MC Cancer Institute, Rotterdam 3015 GE, The Netherland.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Haeri
authors.affiliation: Laboratory Experimental Surgical Oncology, Department of Surgery, Erasmus MC Cancer Institute, Rotterdam 3015 GE, The Netherland.
authors.forename: Timo L M
authors.initials: TL
authors.lastname: Ten Hagen
authors.affiliation: Department of Chemistry and Edaphology, University of Navarra, 31008 Pamplona, Spain.
authors.forename: Iñigo
authors.initials: I
authors.lastname: Navarro
authors.affiliation: Laboratory Experimental Surgical Oncology, Department of Surgery, Erasmus MC Cancer Institute, Rotterdam 3015 GE, The Netherland. Electronic address: g.koning@erasmusmc.nl.
authors.forename: Gerben
authors.initials: G
authors.lastname: Koning
authors.affiliation: Department of Pharmacy and Pharmaceutical Technology, University of Navarra, 31008 Pamplona, Spain. Electronic address: mgarrido@unav.es.
authors.forename: María J
authors.initials: MJ
authors.lastname: Garrido
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000737:chemistry / Q000627:therapeutic use; D045744:Cell Line, Tumor; D000068818:Cetuximab / Q000008:administration & dosage* / Q000737:chemistry / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D006801:Humans; D008081:Liposomes; D008819:Mice, Nude; D009944:Organoplatinum Compounds / Q000008:administration & dosage* / Q000737:chemistry / Q000627:therapeutic use; D000077150:Oxaliplatin; D047368:Tumor Burden / Q000187:drug effects
chemical_list: D000970:Antineoplastic Agents; D008081:Liposomes; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; C512478:EGFR protein, human; D066246:ErbB Receptors; D000068818:Cetuximab
keywords: 1,1′-Dioctadecyl-3,3,3′,3′-tetramethylindocarbocyanine perchlorate (PubChem CID: 16212735); 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[Maleimide (polyethylene glycol) 2000] (PubChem CID:406950); 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[Methoxy (polyethylenglycol)-2000] (PubChem CID: 406952); 3-(2-Pyridyldithio)propionic-acid-N-hydroxysuccinimide-ester (PubChem CID: 100682); Cetuximab; Cholesterol (PubChem CID:5997); Colorectal cancer; EGFR; Fab′; Hydrogenatedphosphatidylcholine (PubChem CID: 94190); Oxaliplatin; Oxaliplatin (PubChem CID: 5310940); Targeted liposomes; Tris(2-carboxyethyl)-phosphine-hydrochloride (PubChem CID: 2734570); β-Mercaptoethanol (PubChem CID: 1567)