WO2003022265A1 - Oily paclitaxel composition and formulation for chemoembolization and preparation method thereof - Google Patents
Oily paclitaxel composition and formulation for chemoembolization and preparation method thereof Download PDFInfo
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- WO2003022265A1 WO2003022265A1 PCT/KR2001/001614 KR0101614W WO03022265A1 WO 2003022265 A1 WO2003022265 A1 WO 2003022265A1 KR 0101614 W KR0101614 W KR 0101614W WO 03022265 A1 WO03022265 A1 WO 03022265A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K49/00—Preparations for testing in vivo
- A61K49/04—X-ray contrast preparations
- A61K49/0433—X-ray contrast preparations containing an organic halogenated X-ray contrast-enhancing agent
- A61K49/0447—Physical forms of mixtures of two different X-ray contrast-enhancing agents, containing at least one X-ray contrast-enhancing agent which is a halogenated organic compound
- A61K49/0452—Solutions, e.g. for injection
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L24/00—Surgical adhesives or cements; Adhesives for colostomy devices
- A61L24/001—Use of materials characterised by their function or physical properties
- A61L24/0015—Medicaments; Biocides
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
- A61K31/337—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having four-membered rings, e.g. taxol
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
- A61K47/44—Oils, fats or waxes according to two or more groups of A61K47/02-A61K47/42; Natural or modified natural oils, fats or waxes, e.g. castor oil, polyethoxylated castor oil, montan wax, lignite, shellac, rosin, beeswax or lanolin
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K49/00—Preparations for testing in vivo
- A61K49/04—X-ray contrast preparations
- A61K49/0433—X-ray contrast preparations containing an organic halogenated X-ray contrast-enhancing agent
- A61K49/0438—Organic X-ray contrast-enhancing agent comprising an iodinated group or an iodine atom, e.g. iopamidol
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
Definitions
- the present invention relates to oily paclitaxel composition and formulation for transcatheter arterial chemoembolization (TACE) by solubilizing paclitaxel and the preparation method thereof.
- TACE transcatheter arterial chemoembolization
- TACE is a cancer treatment method that prevents the nutrition supplies to the cancer tissue by injecting embolizing materials and anticancer agents though the feeding artery of tumor while visualizing the operation process with contrast medium.
- the most widely used TACE is transcatheter arterial chemoembolization through hepatic artery for the treatment of hepatoma.
- the contrast medium serves as a visualization tool during and after the operation and also causes embolism in the tumor.
- the anticancer drugs such as doxorubicin (adriamycin), cisplatin and carboplatin are dissolved or suspended in oily contrast medium.
- TACE contrast media
- the suspension system comprising Lipiodol and above- mentioned anticancer drugs, however, is physically unstable and therefore has many limitations during the operation.
- the anticancer agents such as doxorubicin and epirubicin are used conventionally for the treatment of hepatoma in Radiology.
- Most of the anticancer agents are water-soluble materials. Therefore, suspension type formulation, rather than oily solution, was used in TACE (Yoshihiro Katagiri et al., Cancer Chemother. Pharmacol 1989, 23, 238-242).
- the suspension type formulation cannot be stored for a prolonged period of time since particles aggregate upon storage.
- the anticancer drug is dissolved in the aqueous contrast medium before dispersing the aqueous phase in the oily contrast medium such as Lipiodol®.
- the anticancer drug is dissolved in the aqueous contrast medium and mixed with oily contrast medium by pumping method just before administering to a patient.
- aqueous contrast mediums such as Urografin (specific gravity1.328-1.332) or lopamiro (specific gravity 1.17-1.41) are used since they have similar specific gravities with Lipiodol (1.275-1.290)(Takashi Kanematsu et al., Journal of surgical oncology 1984, 25, 218-226, Takafumi lchida et al., Cancer Chemother. Pharmacol 1994, 33, 74-78).
- the unstable emulsion system does not provide enough embolizing effect. In reality, phase separation can be observed inside the catheter during the operation.
- adriamycin is absorbed immediately to the tissue and therefore does not provide an effect of sustained delivery of anticancer drug.
- SMANCS poly(styrene-co-maleic acid)-conjugated neocarzinostatin
- SMANCS can be solubilized in Lipiodol since it has both hydrophilic and hydrophobic properties (Konno, T. and Maeda, H., Targetting chemotherapy of hepatocellular carcinoma. Neoplasms of the liver, Eds. Okuda, K., and Ishak, K. G., Springger-Verlag, Berlin, P343-352).
- SMANCS/Lipiodol formulation has solved the stability problems of adriamycin/Lipiodol formulation, SMANCS/Lipiodol formulation is not widely used due to the high price and severe toxic side effects.
- paclitaxel an anticancer agent, shows excellent cytotoxicity to ovarian cancer, breast cancer, esophagus cancer, melanoma and leukemia.
- Paclitaxel has been commerciallized as intravenous injection Taxol® by Bristol-Myers Squibb Company.
- Paclitaxel is a one of the water-insoluble drug and therefore the solubilization technique has been developed along with the drug itself.
- One of the examples in the solubilization technique is the use of solubilizing agent for systemic administration such as intravenous injection.
- the above-mentioned Taxol® uses Cremophor EL (polyoxyethylene 35 castor oil) and ethanol as solubilizing agents.
- Taxol® is a pre-concentrate type emulsion formulation that forms microemulsion spontaneously when dispersed in excess amount of water (US patent 5438072). It is known, however, that solubilizing agent in Taxol® causes toxic side effects. Therefore, many studies are performed to develop new paclitaxel formulations with high anticancer activity and low toxic effects.
- Paclitaxel has never been used as an anticancer drug for embolization or angiography.
- the object of the present invention is to use paclitaxel in transcatheter arterial chemoembolization by solubilizing paclitaxel.
- one of the objects of the present invention is to provide a new composition of paclitaxel that can solubilize paclitaxel.
- the object of the present invention is to provide an oily paclitaxel formulation that can be used for the treatment of solid tumors by transcatheter arterial chemoembolization
- Another object of the present invention is to provide an oily paclitaxel formulation that can maintain the original composition stably during the transcatheter arterial chemoembolization process.
- Another object of the present invention is to provide a preparation process of the above composition of paclitaxel.
- paclitaxel is soluble in the oily contrast medium to form a homogeneous single phase viscous oily liquid of viscosity ranging 120 - 180 centipoises (cP).
- the paclitaxel/oily contrast medium composition can be stored for a long period of time without changing the composition since it is chemically and physically stable.
- This paclitaxel/oily contrast medium composition has a superior physical properties to the conventional Lipiodol formulations using water-soluble anticancer drugs such as doxorubicin.
- the paclitaxel/oily contrast medium composition of the present invention has similar physical characteristics to SMANCS/Lipiodol formulation. In contrast to the SMANCS/Lipiodol formulation that has to the high price and toxic side effects, however, the paclitaxel/lipiodol composition uses two relatively inexpensive raw materials and very easy to prepare that can lower the production cost. Also the obtained formulation is stable upon storage.
- the oily paclitaxel formulation of the present invention can maintain the original composition stably during the transcatheter arterial chemoembolization process while the conventional Lipiodol/lopamiro/doxorubicin formulation phase- separated immediately after mixing. Therefore, the paclitaxel/oily contrast medium formulation of the present invention can deliver the anticancer drug in a sustained release fashion to the tumor. Also, the formulation can be stored for a long period of time due to its excellent stability. Moreover, the result described hereinbelow shows that the formulation of the present invention has an excellent embolization effect and anticancer activity when TACE was performed through hepatic artery in an animal model. Therefore, it is expected that the formulation of the present invention cab be used in TACE.
- TACE hepatic artery
- SMANCS/Lipiodol formulation has been used for the targeted therapy of renal cancer by performing
- Paclitaxel has never been used as an anticancer drug for embolization or angiography.
- the object of the present invention is to use paclitaxel in transcatheter arterial chemoembolization by solubilizing paclitaxel.
- an oily contrast medium that can be used in preparing the paclitaxel/oily contrast medium composition is an iodized oil.
- the iodized oils include iodized poppy seed oil such as Lipiodol (Laboratoire Guerbet, France), Ethiodol (Savage Laboratories, Melville, NY)) and iodized soybean oil).
- the iodized soybean oil is described by Ma Tai (The effect of oral iodized oil on prevention and treatment of endemic goiter. Chinese Med. J. 61 (9):533, 1981).
- the iodine content of the iodized oil used as an oily contrast medium in the present invention is preferably 30 ⁇ 50 % by weight. More preferably, the iodine content is between 35 ⁇ 45 % by weight. It is the most preferable to use Lipiodol as the oily contrast medium.
- the amount of paclitaxel in the paclitaxel/oily contrast medium of the present invention is 0.0001 ⁇ 10 mg per 1 ml of oily contrast medium.
- amount of paclitaxel exceeds 10 mg, it is not preferable since the excess paclitaxel precipitates.
- anticancer activity is too low when the amount of paclitaxel is lower than 0.0001 mg.
- animal oils such as squalene or vegetable oils such as soybean oil can additionally included in the paclitaxel/oily contrast medium composition of the present invention.
- oily contrast medium By substituting oily contrast medium with animal oils, vegetable oils or their mixture, the cost of producing the formulation can be lowered without sacrificing the efficacy or stability.
- the ratio of oily contrast medium: animal oil and/or vegetable oil is 1 :0.1 ⁇ 1 by volume. More preferably, the above ration is 1 : 0.1 ⁇ 0.5.
- the paclitaxel/oily contrast medium composition of the present invention can be easily prepared by adding paclitaxel to the oily contrast medium according to the above composition range and solubilizing paclitaxel by stirring the mixture at room temperature. To speed up the solubilization process, it is
- the prepared paclitaxel/oily contrast medium composition is stored after sterilization process. It is acceptable to use sterilized raw materials and to mix them under a sterile environment. Or the paclitaxel/oily contrast medium composition can be sterilized by injecting through a sterile syringe filter (pore size
- iodized poppy seed oil and paclitaxel or to sterilize the composition by using gamma ray or EO gas sterilization protocols.
- the paclitaxel/oily contrast medium composition of the present invention prepared as above was stable for more than 60 days at room temperature.
- the amount and the method of the administration of the paclitaxel/oily contrast medium composition of the present invention can be varied up to the decision of the doctor depending on the age, sex, weight, and severeness of the patient.
- TACE can be performed once in 1 ⁇ 4 months and can be repeated.
- Two to 15 ml of the formulation is injected through the feeding artery of a solid tumor, for instance through hepatic artery in case of hepatoma.
- Figure 1 is a computed tomography (CT) picture obtained 1 week after selectively administering 0.3 cc of paclitaxel/lipiodol formulation of the present invention to the rabbit hepatoma by transcatheter arterial chemoembolization.
- CT computed tomography
- the amount of the administered paclitaxel corresponds to A) 1 mg, B) 3 mg and
- Figure 2 is a graph showing the concentration of paclitaxel in the hepatoma and neighboring normal liver tissues one week after selectively administering 0.3 cc of paclitaxel/lipiodol formulation of the present invention to the rabbit hepatoma by transcatheter arterial chemoembolization.
- the quantitative analysis of paclitaxel was performed by high performance liquid chromatography (HPLC).
- HPLC high performance liquid chromatography
- the amount of the administered paclitaxel corresponds to A) 1 mg and B) 3 mg.
- Figure 3 is a graph showing the percent ratio of the viable tumor in total hepatoma tissue one week after selectively administering 0.3 cc (the groups administered with 1 mg and 3 mg of paclitaxel) and 0.4 cc (the group administered with 4 mg of paclitaxel) of paclitaxel/lipiodol formulation of the present invention to the rabbit hepatoma by transcatheter arterial chemoembolization.
- 0.3 cc of Lipiodol the groups administered with 1 mg and 3 mg of paclitaxel
- 0.4 cc the group administered with 4 mg of paclitaxel
- Lipiodol Lipiodol Ultra-fluid, Laboratoire Guerbet, France, Iodine content 38 % by weight
- Lipiodol and 2,4,6,8,10 or 11 mg of paclitaxel were added in test tubes ( micro test tubes with safety lock, polyethylene, 1.5 ml, Eppendorf AG, Germany) and solubilized by stirring at room temperature. To speed up the
- Lipiodol Lipiodol Ultra-fluid, Laboratoire Guerbet, France, Iodine content 38 % by weight
- paclitaxel 10 mg
- HPLC conditions were as follows.
- SP8810 precision isocratic pump (Spectra-Physics Inc., San Jose, CA)
- the oily paclitaxel composition was prepared as described in Example 2. Paclitaxel was completely solubilized in Ethiodol as evidenced by the formation of clear single liquid phase. The physical stability of the prepared composition was tested by the same methods as in Example 2. The prepared composition was sterilized and stored at room
- VX2 tumor provided by Deutsches Krebsforschungstechnik Tumorbank (Germany) was transplanted into the thigh of rabbits (New Zealand White).
- the rabbits having 1 ⁇ 2 cm tumors were sacrificed by intravenous injection of 10 ml of pentothal sodium solution (62.5mg/kg).
- the tumors were excised along with the tissues around them after disinfection with Iodine solution and alcohol, removing the hair and cutting the skin over the tumor site.
- the tumor was cut to remove the central necrotic portion.
- the viable peripheral tumor tissue was mixed with calcium and magnesium-free Hank's balanced salt solution (Grand Island Biological Co., Grand Island, New York) and cut into very small pieces with scissors and surgical mess.
- the tumor solution was mixed with
- RMPI-1640 Rosewell Park Memorial Institute, Rosewell Park, New York. The mixture was diluted to 1 x10 6 tumor cells/mm 3 .
- phosphate buffered saline Five hundred milliliters of phosphate buffered saline was administered through the vein of the ear via 23 G needle as a first step.
- 40 ml of phosphate buffered saline mixed with 500 mg of pentothal sodium was injected at a flow rate of 1 ml/min to anesthetize a rabbit.
- the total dose of the solution was 1.5 ml/kg.
- the hair in the abdomen was removed, and the skin was disinfected with Iodine solution and alcohol.
- 0.1 ml of the tumor tissue solution was injected to the liver parenchyma of the left lobe with a 1 ml syringe through a 22 G needle.
- the tumor tissue solution was injected to the left lobe among the 5 lobes in the rabbit liver since it is the easiest to observe with the ultrasound ( Figure 1).
- antibiotic PenbrexR, 250mg
- the rabbits were grown in a rabbit cage with normal meals.
- tumor was identified by ultrasound observation and CT. The tumor growth could be roughly predicted by the growth curve.
- the ultrasound observation was performed every 3 days, and CT was performed every week starting 2 weeks after the transplantation to follow up the position and size of the tumor.
- Example 4 Transcatheter arterial chemoembolization with paclitaxel/Lipiodol composition in hepatoma animal model
- the prepared composition was sterilized by injecting through a syringe filter (200 ⁇ m
- TACE was performed through a catheter into the feeding artery of the tumor 0.3 ml of the paclitaxel/Lipiodol formulation of the present invention. Therefore, the dose of paclitaxel corresponds to 1 mg and 3 mg, respectively.
- 0.3 cc of Lipiodol was injected to the hepatoma animal model. Lipiodol was taken up selectively into the tumor tissue in one week after the surgery as shown by the computed tomographic picture in Figure 1.
- Example 5 Analysis of paclitaxel concentration in the hepatoma tissue after the transcatheter arterial chemoembolization with paclitaxel/Lipiodol composition
- the rabbits were sacrificed in one week after the transcatheter arterial chemoembolization in Example 4, and livers were taken out.
- the paclitaxel concentration was determined in the tumor tissue that Lipiodol was visually identified, the tumor tissue that Lipiodol is not visually identified and the normal liver tissue neighboring the tumor.
- Each liver tissue was mixed with a lysis
- Example 4 the paclitaxel concentrations in the liver of the rabbits administered with the formulation corresponding to 1 mg or 3 mg of paclitaxel are shown in Figures 2A and 2B, respectively.
- the concentration of paclitaxel in the hepatoma tissue that Lipiodol was visually identified was the highest.
- the concentration was relatively high in the hepatoma tissue that Lipiodol was not visually identified.
- the paclitaxel concentration was negligible in the normal liver tissue neighboring the tumor. Therefore, it was confirmed that paclitaxel distributes selectively in the tumor one week after the operation with the paclitaxel/Lipiodol formulation of the present invention.
- Example 6 Determination of viable tumor after the transcatheter arterial chemoembolization with paclitaxel/Lipiodol composition
- prepared composition was sterilized by injecting through a syringe filter (200 ⁇ m
- TACE was performed through a catheter into the feeding artery of the tumor 0.3 ml (3.33 or 10 mg/ml formulations) or 0.4 ml (10 mg/ml formulation) of the paclitaxel/Lipiodol formulation of the present invention. Therefore, the dose of paclitaxel corresponds to 1 mg, 3 mg or 4 mg, respectively.
- 0.3 cc of Lipiodol was injected to the hepatoma animal model. Lipiodol was taken up selectively into the tumor tissue in one week after the surgery as shown by the computed tomographic picture in Figure 1.
- the rabbits were sacrificed in one week after the transcatheter arterial chemoembolization, and livers were taken out.
- the size of the tumors in the groups administered with the paclitaxel/Lipiodol formulations was similar to the negative control group
- Lipiodol/squalene/paclitaxel composition was prepared by using the same preparation method in Example 6. Paclitaxel was completely solubilized in the mixed oil system of Lipiodol/soybean oil as evidenced by the formation of clear single liquid phase.
- the paclitaxel/oily contrast medium composition of the present invention is a single phase viscous liquid.
- the composition of the present invention opens up a new administration route for paclitaxel, which has been conventionally administered mainly through intravenous injection.
- the composition of the present invention can be used for the treatment of hepatoma by transcatheter arterial chemoembolization.
- the paclitaxel/Lipiodol formulation of the present invention is easy to prepare and to sterilize and is physically and chemically more stable than conventional doxorubicin/Lipiodol formulation. Therefore, the composition is stable during and after the TACE for the treatment of solid tumors, and is stable for at least 60 days at room temperature.
Abstract
Oily paclitaxel composition and formulation for chemoembolization and preparation method thereof solubilizing paclitaxel in an oily contrast medium. The composition of the present invention solubilizes paclitaxel and has an advantage of delivering anticancer drug to the target cells by chemoembolization since it is possible to visualize the blood vessel during the chemoembolization process.
Description
OILY PACLITAXEL COMPOSITION AND FORMULATION FOR CHEMOEMBOLIZATION AND PREPARATION METHOD THEREOF
TECHNICAL FIELD
The present invention relates to oily paclitaxel composition and formulation for transcatheter arterial chemoembolization (TACE) by solubilizing paclitaxel and the preparation method thereof.
TACE is a cancer treatment method that prevents the nutrition supplies to the cancer tissue by injecting embolizing materials and anticancer agents though the feeding artery of tumor while visualizing the operation process with contrast medium.
BACKGROUND ART
The most widely used TACE is transcatheter arterial chemoembolization through hepatic artery for the treatment of hepatoma. The contrast medium serves as a visualization tool during and after the operation and also causes embolism in the tumor. The anticancer drugs such as doxorubicin (adriamycin), cisplatin and carboplatin are dissolved or suspended in oily contrast medium.
One of the most frequently used contrast media in TACE is an iodized oil such as Lipiodol®. The suspension system comprising Lipiodol and above- mentioned anticancer drugs, however, is physically unstable and therefore has many limitations during the operation. The anticancer agents such as doxorubicin and epirubicin are used conventionally for the treatment of hepatoma
in Radiology. Most of the anticancer agents, however, are water-soluble materials. Therefore, suspension type formulation, rather than oily solution, was used in TACE (Yoshihiro Katagiri et al., Cancer Chemother. Pharmacol 1989, 23, 238-242). The suspension type formulation, however, cannot be stored for a prolonged period of time since particles aggregate upon storage.
To overcome this stability problem, the anticancer drug is dissolved in the aqueous contrast medium before dispersing the aqueous phase in the oily contrast medium such as Lipiodol®. In other words, the anticancer drug is dissolved in the aqueous contrast medium and mixed with oily contrast medium by pumping method just before administering to a patient. To maximize the stability of the emulsion, aqueous contrast mediums such as Urografin (specific gravity1.328-1.332) or lopamiro (specific gravity 1.17-1.41) are used since they have similar specific gravities with Lipiodol (1.275-1.290)(Takashi Kanematsu et al., Journal of surgical oncology 1984, 25, 218-226, Takafumi lchida et al., Cancer Chemother. Pharmacol 1994, 33, 74-78). However, only a transient emulsion that phase-separates in a few minutes after preparation is produced by the above method. The unstable emulsion system does not provide enough embolizing effect. In reality, phase separation can be observed inside the catheter during the operation. When this unstable emulsion is administered, adriamycin is absorbed immediately to the tissue and therefore does not provide an effect of sustained delivery of anticancer drug.
One of the ideal hepatoma treatment uses a synthetic polymeric anticancer agent, poly(styrene-co-maleic acid)-conjugated neocarzinostatin (SMANCS). SMANCS can be solubilized in Lipiodol since it has both hydrophilic
and hydrophobic properties (Konno, T. and Maeda, H., Targetting chemotherapy of hepatocellular carcinoma. Neoplasms of the liver, Eds. Okuda, K., and Ishak, K. G., Springger-Verlag, Berlin, P343-352). Even though SMANCS/Lipiodol formulation has solved the stability problems of adriamycin/Lipiodol formulation, SMANCS/Lipiodol formulation is not widely used due to the high price and severe toxic side effects.
On the other hand, paclitaxel, an anticancer agent, shows excellent cytotoxicity to ovarian cancer, breast cancer, esophagus cancer, melanoma and leukemia. Paclitaxel has been commerciallized as intravenous injection Taxol® by Bristol-Myers Squibb Company.
Paclitaxel is a one of the water-insoluble drug and therefore the solubilization technique has been developed along with the drug itself. One of the examples in the solubilization technique is the use of solubilizing agent for systemic administration such as intravenous injection. The above-mentioned Taxol® uses Cremophor EL (polyoxyethylene 35 castor oil) and ethanol as solubilizing agents. Taxol® is a pre-concentrate type emulsion formulation that forms microemulsion spontaneously when dispersed in excess amount of water (US patent 5438072). It is known, however, that solubilizing agent in Taxol® causes toxic side effects. Therefore, many studies are performed to develop new paclitaxel formulations with high anticancer activity and low toxic effects.
SUMMARY OF THE INVENTION
Paclitaxel has never been used as an anticancer drug for embolization or angiography. The object of the present invention is to use paclitaxel in
transcatheter arterial chemoembolization by solubilizing paclitaxel.
Therefore, one of the objects of the present invention is to provide a new composition of paclitaxel that can solubilize paclitaxel.
More particularly, the object of the present invention is to provide an oily paclitaxel formulation that can be used for the treatment of solid tumors by transcatheter arterial chemoembolization
Also, another object of the present invention is to provide an oily paclitaxel formulation that can maintain the original composition stably during the transcatheter arterial chemoembolization process.
Another object of the present invention is to provide a preparation process of the above composition of paclitaxel.
DETAILED DESCRIPTION OF THE INVENTION
While trying to find a paclitaxel formulation that can be used in transcathter arterial chemoembolization to meet the above mentioned expectations, the present inventors have found unexpectedly that paclitaxel is soluble in the oily contrast medium to form a homogeneous single phase viscous oily liquid of viscosity ranging 120 - 180 centipoises (cP).
Also the paclitaxel/oily contrast medium composition can be stored for a long period of time without changing the composition since it is chemically and physically stable. This paclitaxel/oily contrast medium composition has a superior physical properties to the conventional Lipiodol formulations using water-soluble anticancer drugs such as doxorubicin. The paclitaxel/oily contrast
medium composition of the present invention has similar physical characteristics to SMANCS/Lipiodol formulation. In contrast to the SMANCS/Lipiodol formulation that has to the high price and toxic side effects, however, the paclitaxel/lipiodol composition uses two relatively inexpensive raw materials and very easy to prepare that can lower the production cost. Also the obtained formulation is stable upon storage.
The oily paclitaxel formulation of the present invention can maintain the original composition stably during the transcatheter arterial chemoembolization process while the conventional Lipiodol/lopamiro/doxorubicin formulation phase- separated immediately after mixing. Therefore, the paclitaxel/oily contrast medium formulation of the present invention can deliver the anticancer drug in a sustained release fashion to the tumor. Also, the formulation can be stored for a long period of time due to its excellent stability. Moreover, the result described hereinbelow shows that the formulation of the present invention has an excellent embolization effect and anticancer activity when TACE was performed through hepatic artery in an animal model. Therefore, it is expected that the formulation of the present invention cab be used in TACE.
Even though the most typical TACE is TACE through hepatic artery, it can be applied to a variety of solid tumors. For instance, SMANCS/Lipiodol formulation has been used for the targeted therapy of renal cancer by performing
TACE through renal artery (K. Tsuchiya, Tumor-targeted chemotherapy with SMANCS in Lipiodol for renal cell carcinoma: longer survival with larger size tumors. Urology. 2000 Apr;55(4):495-500).
Paclitaxel has never been used as an anticancer drug for embolization or
angiography. The object of the present invention is to use paclitaxel in transcatheter arterial chemoembolization by solubilizing paclitaxel.
An example of an oily contrast medium that can be used in preparing the paclitaxel/oily contrast medium composition is an iodized oil. The iodized oils include iodized poppy seed oil such as Lipiodol (Laboratoire Guerbet, France), Ethiodol (Savage Laboratories, Melville, NY)) and iodized soybean oil). The iodized soybean oil is described by Ma Tai (The effect of oral iodized oil on prevention and treatment of endemic goiter. Chinese Med. J. 61 (9):533, 1981).
The iodine content of the iodized oil used as an oily contrast medium in the present invention is preferably 30 ~ 50 % by weight. More preferably, the iodine content is between 35 ~ 45 % by weight. It is the most preferable to use Lipiodol as the oily contrast medium.
The amount of paclitaxel in the paclitaxel/oily contrast medium of the present invention is 0.0001 ~ 10 mg per 1 ml of oily contrast medium. When the amount of paclitaxel exceeds 10 mg, it is not preferable since the excess paclitaxel precipitates. On the other hand, anticancer activity is too low when the amount of paclitaxel is lower than 0.0001 mg.
Also, animal oils such as squalene or vegetable oils such as soybean oil can additionally included in the paclitaxel/oily contrast medium composition of the present invention. By substituting oily contrast medium with animal oils, vegetable oils or their mixture, the cost of producing the formulation can be lowered without sacrificing the efficacy or stability. The ratio of oily contrast medium: animal oil and/or vegetable oil is 1 :0.1 ~ 1 by volume. More preferably, the above ration is 1 : 0.1 ~ 0.5.
The paclitaxel/oily contrast medium composition of the present invention can be easily prepared by adding paclitaxel to the oily contrast medium according to the above composition range and solubilizing paclitaxel by stirring the mixture at room temperature. To speed up the solubilization process, it is
acceptable to raise the temperature to 35 ~ 45 °C or to sonicate in a bath type
sonicator. The prepared paclitaxel/oily contrast medium composition is stored after sterilization process. It is acceptable to use sterilized raw materials and to mix them under a sterile environment. Or the paclitaxel/oily contrast medium composition can be sterilized by injecting through a sterile syringe filter (pore size
200 μm, PVDF sterile filter). It is also acceptable to sterilize and to mix the
iodized poppy seed oil and paclitaxel or to sterilize the composition by using gamma ray or EO gas sterilization protocols.
The paclitaxel/oily contrast medium composition of the present invention prepared as above was stable for more than 60 days at room temperature.
Also the amount and the method of the administration of the paclitaxel/oily contrast medium composition of the present invention can be varied up to the decision of the doctor depending on the age, sex, weight, and severeness of the patient. Generally, TACE can be performed once in 1 ~ 4 months and can be repeated. Two to 15 ml of the formulation is injected through the feeding artery of a solid tumor, for instance through hepatic artery in case of hepatoma.
The invention will be further illustrated by the following examples. It should be understood that these examples are intended to be illustrative only and the present invention is not limited to the conditions, materials or devices
recited therein.
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a computed tomography (CT) picture obtained 1 week after selectively administering 0.3 cc of paclitaxel/lipiodol formulation of the present invention to the rabbit hepatoma by transcatheter arterial chemoembolization.
The amount of the administered paclitaxel corresponds to A) 1 mg, B) 3 mg and
C) 0 mg.
Figure 2 is a graph showing the concentration of paclitaxel in the hepatoma and neighboring normal liver tissues one week after selectively administering 0.3 cc of paclitaxel/lipiodol formulation of the present invention to the rabbit hepatoma by transcatheter arterial chemoembolization. The quantitative analysis of paclitaxel was performed by high performance liquid chromatography (HPLC). The amount of the administered paclitaxel corresponds to A) 1 mg and B) 3 mg.
Figure 3 is a graph showing the percent ratio of the viable tumor in total hepatoma tissue one week after selectively administering 0.3 cc (the groups administered with 1 mg and 3 mg of paclitaxel) and 0.4 cc (the group administered with 4 mg of paclitaxel) of paclitaxel/lipiodol formulation of the present invention to the rabbit hepatoma by transcatheter arterial chemoembolization. In case of the negative control group, 0.3 cc of Lipiodol
was administered.
EXAMPLES
Example 1. Preparation of paclitaxel/Lipiodol composition
One milliliter of Lipiodol (Lipiodol Ultra-fluid, Laboratoire Guerbet, France, Iodine content 38 % by weight) was used as an oily contrast medium. Lipiodol and 2,4,6,8,10 or 11 mg of paclitaxel (Samyang Genex, Korea) were added in test tubes ( micro test tubes with safety lock, polyethylene, 1.5 ml, Eppendorf AG, Germany) and solubilized by stirring at room temperature. To speed up the
solubilization process, it is acceptable to raise the temperature to 35 ~ 45 °C or
to sonicate in a bath type sonicator. When 2 ~ 10 mg of paclitaxel was added in 1 ml of Lipiodol, paclitaxel was completely solubilized in Lipiodol as evidenced by the formation of clear single liquid phase. When 11 mg of paclitaxel was added to 1 ml of Lipiodol, however, clear liquid was formed initially but the turbidity of the solution increased after overnight storage at room temperature. Paclitaxel precipitation was observed under a microscopy. Therefore, it was confirmed that the solubility of paclitaxel in Lipiodol is approximately 10 mg/ml at room
temperature (24 ~ 28 °C). Viscosity of the paclitaxel/lipiodol (10 mg/1 ml)
formulation was measured using a Kinematic viscometer Cannon-Fenske Type, Calibrated, Cat. No. 13-617E, Size 200, Fisher Scientific, Pittsburgh, PA) by measuring the falling time of the liquid formulation. The viscosity was 151 cP,
which is higher value than the viscosity of Lipiodol, 4.4 cP at 25 °C. Since the
viscosity was higher than 45 cP, embolization effect is maximized, it is expected that paclitaxel/Lipiodol composition has an excellent embolization effect.
Example 2. Physical stability of paclitaxel/Lipiodol composition
One milliliter of Lipiodol (Lipiodol Ultra-fluid, Laboratoire Guerbet, France,
Iodine content 38 % by weight) and 10 mg of paclitaxel (Samyang Genex, Korea) were added in test tubes and solubilized by stirring at room temperature. To speed up the solubilization process, the temperature of the mixture was raised to
40 °C. Paclitaxel was completely solubilized in Lipiodol as evidenced by the
formation of clear single liquid phase. The prepared composition was sterilized
by injecting through a syringe filter (200 μm pore size, PVDF filter) and stored at
room temperature and at 4 °C for 60 days to observe the physical stability and
the degradation of paclitaxel. There was no change in the color and odor of the formulation. Phase separation or precipitation did not occur. Degradation of paclitaxel was not observed as evidenced by the analysis performed by HPLC.
The HPLC conditions were as follows.
- Pump: SP8810 precision isocratic pump (Spectra-Physics Inc., San Jose, CA)
- Column: Waters Bondpack C18 Column (3.9 mm x 300 mm, Waters Corp., Milford, MA)
- Mobile phase: acetonitrile and water 50 %(w/w) each
- Flow rate:1 ml/min
- Detector: Spectra 100 variable wavelength (Spectra-Physics)
Example 3. Physical stability of paclitaxel/Ethiodol composition
Except that Ethiodol (Savage Laboratories, Melville, NY) was used instead of Lipiodol as an oily contrast medium, the oily paclitaxel composition was prepared as described in Example 2. Paclitaxel was completely solubilized in Ethiodol as evidenced by the formation of clear single liquid phase. The
physical stability of the prepared composition was tested by the same methods as in Example 2. The prepared composition was sterilized and stored at room
temperature and at 4 °C for 60 days to observe the physical stability and the
degradation of paclitaxel. There was no change in the color and odor of the formulation. Phase separation or precipitation did not occur. Degradation of paclitaxel was not observed as evidenced by the analysis performed by HPLC.
Experimental Example 1. Preparation of Hepatoma animal model
VX2 tumor provided by Deutsches Krebsforschungszentrum Tumorbank (Germany) was transplanted into the thigh of rabbits (New Zealand White).
After 2 weeks, the rabbits having 1~2 cm tumors were sacrificed by intravenous injection of 10 ml of pentothal sodium solution (62.5mg/kg). The tumors were excised along with the tissues around them after disinfection with Iodine solution and alcohol, removing the hair and cutting the skin over the tumor site. The tumor was cut to remove the central necrotic portion. The viable peripheral tumor tissue was mixed with calcium and magnesium-free Hank's balanced salt solution (Grand Island Biological Co., Grand Island, New York) and cut into very small pieces with scissors and surgical mess. The tumor solution was mixed with
5 ml of RMPI-1640 (Rosewell Park Memorial Institute, Rosewell Park, New York). The mixture was diluted to 1 x106 tumor cells/mm3.
Injection of tumors cell solution into rabbit liver
Five hundred milliliters of phosphate buffered saline was administered
through the vein of the ear via 23 G needle as a first step. Through this rabbit vein, 40 ml of phosphate buffered saline mixed with 500 mg of pentothal sodium was injected at a flow rate of 1 ml/min to anesthetize a rabbit. The total dose of the solution was 1.5 ml/kg. The hair in the abdomen was removed, and the skin was disinfected with Iodine solution and alcohol. Under the ultrasound guide, 0.1 ml of the tumor tissue solution was injected to the liver parenchyma of the left lobe with a 1 ml syringe through a 22 G needle. The tumor tissue solution was injected to the left lobe among the 5 lobes in the rabbit liver since it is the easiest to observe with the ultrasound (Figure 1). To prevent secondary infection, antibiotic (PenbrexR, 250mg) was injected intravenously. After the injection of the tumor tissue solution, the rabbits were grown in a rabbit cage with normal meals. In two weeks after the transplantation of tumor cells, tumor was identified by ultrasound observation and CT. The tumor growth could be roughly predicted by the growth curve. The ultrasound observation was performed every 3 days, and CT was performed every week starting 2 weeks after the transplantation to follow up the position and size of the tumor.
Example 4. Transcatheter arterial chemoembolization with paclitaxel/Lipiodol composition in hepatoma animal model
One milliliter of Lipiodol and 3.33 mg or 10 mg each of paclitaxel
(Samyang Genex, Korea) were added in test tubes and solubilized by stirring at room temperature. To speed up the solubilization process, the temperature of
the mixture was raised to 40 °C. Paclitaxel was completely solubilized in
Lipiodol as evidenced by the formation of clear single liquid phase. The
prepared composition was sterilized by injecting through a syringe filter (200 μm
pore size, PVDF filter).
In the hepatoma animal model prepared in Experimental Example 1 , TACE was performed through a catheter into the feeding artery of the tumor 0.3 ml of the paclitaxel/Lipiodol formulation of the present invention. Therefore, the dose of paclitaxel corresponds to 1 mg and 3 mg, respectively. As a negative control group, 0.3 cc of Lipiodol was injected to the hepatoma animal model. Lipiodol was taken up selectively into the tumor tissue in one week after the surgery as shown by the computed tomographic picture in Figure 1.
Example 5. Analysis of paclitaxel concentration in the hepatoma tissue after the transcatheter arterial chemoembolization with paclitaxel/Lipiodol composition
The rabbits were sacrificed in one week after the transcatheter arterial chemoembolization in Example 4, and livers were taken out. The paclitaxel concentration was determined in the tumor tissue that Lipiodol was visually identified, the tumor tissue that Lipiodol is not visually identified and the normal liver tissue neighboring the tumor. Each liver tissue was mixed with a lysis
buffer solution [62.5 mM Tris-HCI (pH 6.8), 2% sodium dodecyl sulfate, 5% β-
mercaptoethanol, 10% glycerol] and homogenized. After the homogenized mixture was centrifuged, the supernatant was obtained to analyze the paclitaxel concentration by HPLC. The conditions for HPLC were identical to those in Example 2. As explained in Example 4, the paclitaxel concentrations in the liver of the rabbits administered with the formulation corresponding to 1 mg or 3 mg of paclitaxel are shown in Figures 2A and 2B, respectively. The concentration of
paclitaxel in the hepatoma tissue that Lipiodol was visually identified was the highest. The concentration was relatively high in the hepatoma tissue that Lipiodol was not visually identified. On the other hand, the paclitaxel concentration was negligible in the normal liver tissue neighboring the tumor. Therefore, it was confirmed that paclitaxel distributes selectively in the tumor one week after the operation with the paclitaxel/Lipiodol formulation of the present invention.
Example 6. Determination of viable tumor after the transcatheter arterial chemoembolization with paclitaxel/Lipiodol composition
One milliliter of Lipiodol and 3.33 mg or 10 mg each of paclitaxel (Samyang Genex, Korea) were added in test tubes and solubilized by stirring at room temperature. To speed up the solubilization process, the temperature of
the mixture was raised to 40 °C. Paclitaxel was completely solubilized in
Lipiodol as evidenced by the formation of clear single liquid phase. The
prepared composition was sterilized by injecting through a syringe filter (200 μm
pore size, PVDF filter).
In the hepatoma animal model prepared in Experimental Example 1 , TACE was performed through a catheter into the feeding artery of the tumor 0.3 ml (3.33 or 10 mg/ml formulations) or 0.4 ml (10 mg/ml formulation) of the paclitaxel/Lipiodol formulation of the present invention. Therefore, the dose of paclitaxel corresponds to 1 mg, 3 mg or 4 mg, respectively. As a negative control group, 0.3 cc of Lipiodol was injected to the hepatoma animal model. Lipiodol was taken up selectively into the tumor tissue in one week after the
surgery as shown by the computed tomographic picture in Figure 1. The rabbits were sacrificed in one week after the transcatheter arterial chemoembolization, and livers were taken out. The size of the tumors in the groups administered with the paclitaxel/Lipiodol formulations was similar to the negative control group
administered with Lipiodol and was 32 ± 5 mm. Pathological examination was
performed to distinguish necrotic tumor and viable tumor in the tumor tissue. The viable tumor portion in the total tumor tissue is shown in Figure 3. In the negative control group, more than 30 % of the tumor was viable whereas the viable tumor was 13.2 %, 10.4 % and 0.6 % in the groups of rabbits administered with 1 mg, 3 mg and 4 mg, respectively, of paclitaxel. These result indicate that paclitaxel in the paclitaxel/Lipiodol formulation of the present invention effectively destroys tumor cells.
Example 7. Preparation of Lipiodol/soybean oil/paclitaxel composition
One. milliliter of Lipiodol, 0.2 ml of soybean oil and 10 mg each of paclitaxel were added in test tubes and solubilized by stirring at room temperature. To speed up the solubilization process, the mixture was sonicated in a bath type sonicator. Paclitaxel was completely solubilized in the mixed oil system of Lipiodol/soybean oil as evidenced by the formation of clear single liquid phase.
Example 8 Preparation of Lipiodol/squalene/paclitaxel composition
Except that squalene was used instead of soybean oil, and the mixture
was heated to 40 °C to speed up the solubilization process,
Lipiodol/squalene/paclitaxel composition was prepared by using the same preparation method in Example 6. Paclitaxel was completely solubilized in the mixed oil system of Lipiodol/soybean oil as evidenced by the formation of clear single liquid phase.
EFFECT OF THE INVENTION
The paclitaxel/oily contrast medium composition of the present invention is a single phase viscous liquid. The composition of the present invention opens up a new administration route for paclitaxel, which has been conventionally administered mainly through intravenous injection. The composition of the present invention can be used for the treatment of hepatoma by transcatheter arterial chemoembolization. The paclitaxel/Lipiodol formulation of the present invention is easy to prepare and to sterilize and is physically and chemically more stable than conventional doxorubicin/Lipiodol formulation. Therefore, the composition is stable during and after the TACE for the treatment of solid tumors, and is stable for at least 60 days at room temperature.
Claims
1. A composition comprising 0.0001 mg ~ 10 mg of paclitaxel in 1 ml of an oily contrast medium for chemoembolization.
2. The composition for chemoembolization of Claim 1 wherein the oily contrast medium is an iodized oil of iodine content ranging 30 ~ 50 % by weight selected from the group consisting of iodized poppy seed oil including Lipiodol and Ethiodol and iodized soybean oil.
3. The composition for chemoembolization of Claim 2 wherein the iodine content of the oily contrast medium is 35 ~ 48 % by weight.
4. The composition for chemoembolization of Claim 2 wherein the oily contrast medium is iodized poppy seed oil with the iodine content of 35 ~
48 % by weight.
5. The composition for chemoembolization of Claim 1 further comprising 0.1 ~ 1 ml of animal oil, vegetable oil or their mixture in 1 ml of the oily contrast medium.
6. The composition for chemoembolization of Claim 5 wherein the animal oil is squalene and vegetable oil is soybean oil.
7. The composition for chemoembolization of Claim 1 or Claim 6 for the treatment of a solid tumor.
8. The composition for transcatheter arterial chemoembolization of Claim 7 wherein the solid tumor is hepatoma.
9. A single-phase oily paclitaxel formulation for chemoembolization comprising 0.0001 mg ~ 10 mg of paclitaxel per 1 ml of oily contrast medium and having viscosity of 120 - 180 cP at room temperature.
10. The oily paclitaxel formulation for chemoembolization of Claim 9 wherein the oily contrast medium is an iodized oil of iodine content ranging 30 ~ 50 % by weight selected from the group consisting iodized poppy seed oil including Lipiodol and Ethiodol and iodized soybean oil.
11. The oily paclitaxel formulation for chemoembolization of Claim 10 wherein the iodine content of the oily contrast medium is 35 ~ 48 % by weight.
12. The oily paclitaxel formulation for chemoembolization of Claim 10 wherein the oily contrast medium is iodized poppy seed oil with the iodine content of 35 - 48 % by weight.
13. The oily paclitaxel formulation for chemoembolization of Claim 9 further comprising 0.1 ~ 1 ml of animal oil, vegetable oil or their mixture in 1 ml of the oily contrast medium.
14. The oily paclitaxel formulation for chemoembolization of Claim 13 wherein the animal oil is squalene and vegetable oil is soybean oil.
15. The oily paclitaxel formulation for chemoembolization of Claim 9 or Claim 14 for the treatment of a solid tumor.
16. The oily paclitaxel formulation for transcatheter arterial chemoembolization of Claim 15 wherein the solid tumor is hepatoma.
17. A method of preparing the oily paclitaxel formulation for chemoembolization comprising the steps of mixing 0.0001 mg ~ 10 mg of paclitaxel per 1 ml of oily contrast medium and solubilizing paclitaxel by stirring.
18. The preparation method of Claim 17 including the step of mixing the sterilized oily contrast medium and paclitaxel under sterilized conditions or the step of sterilizing the mixture after preparation by EO gas or gamma ray.
19. The preparation method of Claim 17 or Claim 18 wherein the mixture is
heated to 35 ~ 45 °C or sonicated.
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US5888546A (en) * | 1995-08-28 | 1999-03-30 | The Regents Of The University Of California | Embolic material for endovascular occlusion of abnormal vasculature and method for using the same |
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