An evolutionary approach to cancer chemotherapy scheduling

In this paper, we investigate the employment of evolutionary algorithms as a search mechanism in a decision support system for designing chemotherapy schedules. Chemotherapy involves using powerful anti-cancer drugs to help eliminate cancerous cells and cure the condition. It is given in cycles of treatment alternating with rest periods to allow the body to recover from toxic side-effects. The number and duration of these cycles would depend on many factors, and the oncologist would schedule a treatment for each patient’s condition. The design of a chemotherapy schedule can be formulated as an optimal control problem; using an underlying mathematical model of tumour growth (that considers interactions with the immune system and multiple applications of a cycle-phase-specific drug), the objective is to find effective drug schedules that help eradicate the tumour while maintaining the patient health’s above an acceptable level. A detailed study on the effects of different objective functions, in the quality and diversity of the solutions, was performed. A term that keeps at a minimum the tumour levels throughout the course of treatment was found to produce more regular treatments, at the expense of imposing a higher strain on the patient’s health, and reducing the diversity of the solutions. Moreover, when the number of cycles was incorporated in the problem encoding, and a parsimony pressure added to the objective function, shorter treatments were obtained than those initially found by trial and error.

A reconstituted thermosensitive hydrogel system based on paclitaxel-loaded amphiphilic copolymer nanoparticles and antitumor efficacy

Combination delivery systems composed of injectable hydrogels and drug-incorporated nanoparticles are urgently in regional cancer chemotherapy to facilitate efficient delivery of chemotherapeutic agents, enhance antitumor efficiency, and decrease side effects. Here, we developed a novel thermosensitive amphiphilic triblock copolymer consisting of methoxy poly(ethylene glycol), poly(octadecanedioic anhydride), and d,l-lactic acid oligomer (PEOALA), built a combination system of thermosensitive injectable hydrogel PTX/PEOALA^Gel based on paclitaxel (PTX)-loaded PEOALA nanoparticles (NPs). PTX/PEOALA^Gel could be stored as freeze-dried powders of paclitaxel-loaded PEOALA NPs, which could be easily redispersed into the water at ambient temperature, and form a hydrogel at the injected site in vivo. The in vitro cytotoxicity of PTX/PEOALA^Gel showed no obvious cytotoxicity in comparison with Taxol® against MCF-7 and HeLa cells. However, the in vivo antitumor activity showed that a single intratumoral injection of the PTX/PEOALA^Gel formulation was more effective than four intravenous (i.v.) injections of Taxol^® at a total dosage of 20?mg/kg in inhibiting the growth of MCF-7 tumor-bearing Balb/c mice, and the inhibition could be sustained for more than 17 d. The pharmacokinetic study demonstrated that the intratumoral injection of PTX/PEOALA^Gel could greatly decrease the systemic exposure of PTX, as confirmed by the rather low plasma concentration, and prolonged circulation time and enhanced tumor PTX accumulation, implying fewer off-target side effects. In summary, the PTX/PEOALA^Gel combination local delivery system could enhance tumor inhibition effect and tumor accumulation of PTX, and lower the systemic exposure. So, the reconstituted PTX/PEOALA^Gel system could potentially be a useful vehicle for regional cancer chemotherapy.     

Near‐Infrared Upconversion Mesoporous Cerium Oxide Hollow Biophotocatalyst for Concurrent pH‐/H2O2‐Responsive O2‐Evolving Synergetic Cancer Therapy

Tumor hypoxia is typically presented in the central region of solid tumors, which is mainly caused by an inadequate blood flow and oxygen supply. In the conventional treatment of hypoxic human tumors, not only the oxygen‐dependent photodynamic therapy (PDT), but also antitumor drug‐based chemotherapy, is considerably limited. The use of direct oxygen delivering approach with oxygen‐dependent PDT or chemotherapy may potentiate the reactive oxygen species (ROS)‐mediated cytotoxicity of the drug toward normal tissues. Herein, a synergetic one‐for‐all mesoporous cerium oxide upconversion biophotocatalyst is developed to achieve intratumorally endogenous H₂O₂‐responsive self‐sufficiency of O₂ and near‐infrared light controlled PDT simultaneously for overcoming hypoxia cancer. Furthermore, the sufficient O₂ plays an important role in overcoming the chemotherapeutic drug‐resistant cancer caused by hypoxia, therefore inducing tumor cell apoptosis significantly.     

Catalytically Selective Chemotherapy from Tumor‐Metabolic Generated Lactic Acid

Lactic acid (LA) is a powerful molecule as the metabolic driver in tumor microenvironments (TMEs). Inspired by its high intratumoral level (5–20 µmol g^?1), a novel treatment paradigm via the cascade release of H₂O₂ and ·OH from the LA generated by tumor metabolism is developed for catalytic and pH‐dependent selective tumor chemotherapy. By utilizing the acidity and overexpression of LA within the TME, the constructed lactate oxidase (LOD)‐immobilized Ce‐benzenetricarboxylic acid (Ce‐BTC) metal organic framework enables the intratumoral generation of ·OH via a cascade reaction: 1) the in situ catalytic release of H₂O₂ from LA by LOD, and 2) the catalytic production of ·OH from H₂O₂ by Ce‐BTC with peroxidase‐like activity. Highly toxic ·OH effectively induces tumor apoptosis/death. A new strategy for selective tumor chemotherapy is provided herein.     

Doxorubicin- and cisplatin-loaded nanostructured lipid carriers for breast cancer combination chemotherapy

Context: Combination anticancer therapy is promising to generate synergistic anticancer effects, to maximize the treatment effect and to overcome multi-drug resistance. Nanostructured lipid carriers (NLCs), composed of solid and liquid lipids, and surfactants are potentially good colloidal drug carriers.

Objective: The aim of this study is to construct novel NLCs as nanocarriers for co-delivery of doxorubicin (DOX) and cisplatin (CDDP) to treat breast cancer.

Methods: DOX and CDDP loaded NLCs (D–C-NLCs) were prepared by the solvent diffusion method. The in vitro cytotoxicity and synergistic studies of different formulations were evaluated on human breast cancer cells (doxorubicin resistant) (MCF-7/ADR cells). In vivo anti-tumor effects were observed on the murine bearing MCF-7/ADR cells model.

Results: D–C-NLCs showed the highest cytotoxicity and synergistic effect of two drugs in tumor cells in vitro. The in vivo study revealed the greatest anti-tumor activity than the other formulations in the breast cancer model.

Conclusion: The constructed NLCs could be used as a novel carrier for co-delivery of DOX and CDDP for breast cancer therapy. D–C-NLCs could be a promising targeted and combinational therapy nanomedicine.     

Targeted hepatocellular carcinoma therapy: transferrin modified,self-assembled polymeric nanomedicine for co-delivery of cisplatin and doxorubicin

Background: Targeted hepatocellular carcinoma (HCC) therapy was carried out to improve the efficacy of liver cancers. The aim of this study was to develop transferrin (Tf) modified, self-assembled polymeric nanoparticles for co-delivery doxorubicin (DOX) and cisplatin (DDP), to achieve combination tumor therapy.

Methods: Tf modified polyethylene glycol (PEG) containing DOX prodrug (Tf-PEG-DOX) was synthesized. DDP containing poly(lactic-co-glycolic) acid (PLGA) materials (PLGA-DDP) were prepared. Tf modified DOX and DDP loaded PLGA nanoparticles (Tf-DOX/DDP NPs) were prepared by using nanoprecipitation method. The particles sizes, zeta potentials, drug loading effects were characterized. The cytotoxicity of the NPs was evaluated in human hepatoma carcinoma cell lines (HepG2 cells), and in vivo anti-tumor was observed in mice bearing human HepG2 cells model.

Results: Tf-DOX/DDP NPs displayed higher cytotoxicity and enhanced antitumor activity both in vitro and in vivo over their non-modified and single drug loaded counterparts.

Conclusion: Tf-DOX/DDP NPs can achieve outstanding anti-tumor activity due to the combination effect of two drugs and the active targeting ability of Tf ligands. The self-assembled polymeric nanomedicine could act as an efficient therapy method for HCC treatment.     

Tumor Microenvironment-Activatable Nanoenzymes for Mechanical Remodeling of Extracellular Matrix and Enhanced Tumor Chemotherapy

Increased tissue stiffness is a hallmark of cancer and promotes tumor progression. It is hypothesized that decreased tumorous stress may aid or sensitize chemotherapies. To overcome extracellular matrix (ECM) stiffening and fulfill sensitized chemotherapy in one nanosystem, a reactive oxygen species-activatable nanoenzyme (SP-NE) based on a dendritic polyglycerol scaffold, integrating collagenase and paclitaxel (PTX) prodrug, is constructed. The dense and tough ECM is highly remitted by SP-NE in the tumor microenvironment (TME) mimicking gelatin hydrogel models, which causes cell shrinkage, disorders cytoskeletal constructions, and subsequently enhances chemotherapeutic efficacy. ECM softening via SP-NE downregulates mechanotransduction signaling pathways of integrin-focal adhesion kinase (FAK)-Ras homolog family member A (RhoA) implicated in cytoskeletal assembly, and integrin-FAK-phosphorylated extracellular signal regulated kinase (pERK 1/2) mediating mitosis. Notably, this programmed nanosystem in human breast MCF-7 tumor-bearing mice models displays a significant relief of ECM stress from 4300 to 1200 Pa and results in 87.1% suppression of tumor growth at a low PTX dosage of 3 mg kg⁻¹. The attenuated expression of the key players RhoA and pERK 1/2 involved in cellular mechano-sensing is further verified in vivo. This study thus provides a new and potential nanoplatform to selectively decrease TME stiffness for enhanced chemotherapy.     

Fabrication of Glyco‐Metal‐Organic Frameworks for Targeted Interventional Photodynamic/Chemotherapy for Hepatocellular Carcinoma through Percutaneous Transperitoneal Puncture

Hepatocellular carcinoma (HCC) causes high morbidity and mortality due to a lack of adequate treatments. Cancer treatments have benefited from nanotechnology approaches that integrate multimodal synergistic therapies. A synergistic, minimally invasive strategy of interventional photodynamic therapy (IPDT) and chemotherapy for HCC treatment through percutaneous transperitoneal puncture is disclosed that is based on photosensitive porphyrinic galactose‐modified metal‐organic frameworks (PCN‐224) first used as hepatic targeting and encapsulated with anticancer drug doxorubicin (DOX@Gal‐PCN‐224). Real‐time imaging reveals the effective accumulation of the integrated nanosystem in the HCC cells and tumor tissues due to hepatic targeting. Evaluation of the anti‐tumor efficiency of this nanosystem on orthotopic transplantation tumors with the aid of minimally invasive intervention shows a tumor inhibition rate of 98%. The synergistic effects induce high‐level cell apoptosis and tissue necrosis in vitro and in vivo. This bimodal IPDT/chemotherapy strategy holds great potential in the clinical treatment for HCC.     

功能化硼纳米双载药复合物的制备及其体外药物释放

通过耦合热氧化蚀刻与液相剥离技术制备了硼纳米片(B NSs),随后用氨基化PEG(H2N-PEG-NH2)对B NSs进行改性制备了改性聚乙二醇化硼纳米片(B-PEG NSs),再以环精氨酸-甘氨酸-天冬氨酸(c RGD)三肽为单体,1-(3-二甲氨基丙基)-3-乙基碳二亚胺盐酸盐(EDC)与N-羟基琥珀酰亚胺(NHS)为引发剂制备了B-PEG-c RGD复合材料。最后,B-PEG-c RGD与阿霉素(DOX)和热休克蛋白90抑制剂17-丙烯胺基-17-去甲氧基格尔德霉素(17AAG)共混得到DOX-17AAG@B-PEG-cRGD纳米载药复合物。采用透射电子显微镜(TEM)、紫外分光光度计及动态光散射仪(DLS)对BNSs和载药复合物的形貌、结构进行了表征。结果表明,功能化硼载药复合物的流体动力学平均直径约为184nm,具有良好的稳定性。体外释药研究表明,DOX-17AAG@B-PEG-cRGD复合物具有近红外光(NIR)和pH双响应性以及良好的药物缓释效果。当体外微环境pH=5.0且存在NIR时,DOX和17AAG在72 h内的累计释放率最高达66.53%和73.01%。     

FLT3 Tyrosine Kinase Inhibitors for the Treatment of Fit and Unfit Patients with FLT3-Mutated AML: A Systematic Review

FLT3-mutated acute myeloid leukemia accounts for around 30% of acute myeloid leukemia (AML). The mutation carried a poor prognosis until the rise of tyrosine kinase inhibitors (TKIs). New potent and specific inhibitors have successfully altered the course of the disease, increasing the complete response rate and the survival of patients with FLT3-mutated AML. The aim of this article is to review all the current knowledge on these game-changing drugs as well as the unsolved issues raised by their use for fit and unfit FLT3-mutated AML patients. To this end, we analyzed the results of phase I, II, III clinical trials evaluating FLT3-TKI both in the first-line, relapse monotherapy or in combination referenced in the PubMed, the American Society of Hematology, the European Hematology Association, and the Clinicaltrials.gov databases, as well as basic science reports on TKI resistance from the same databases. The review follows a chronological presentation of the different trials that allowed the development of first- and second-generation TKI and ends with a review of the current lines of evidence on leukemic blasts resistance mechanisms that allow them to escape TKI.