Skip to main content
British Journal of Cancer logoLink to British Journal of Cancer
. 1991 Dec;64(6):1125–1132. doi: 10.1038/bjc.1991.476

Pharmacokinetic and imaging studies in patients receiving a formulation of liposome-associated adriamycin.

A Gabizon 1, R Chisin 1, S Amselem 1, S Druckmann 1, R Cohen 1, D Goren 1, I Fromer 1, T Peretz 1, A Sulkes 1, Y Barenholz 1
PMCID: PMC1977867  PMID: 1764376

Abstract

Pharmacokinetic and imaging studies in 19 patients receiving liposome-entrapped adriamycin (L-ADM) were carried out within the framework of a Phase I clinical trial (Gabizon et al., 1989a). The formulation of L-ADM tested consisted of 0.2 microM-extruded multilamellar vesicles composed of egg phosphatidylcholine, egg-derived phosphatidyl-glycerol (PG), cholesterol, and ADM intercalated in the fluid lipid bilayer. Plasma clearance of total drug extracted from the plasma after L-ADM infusion followed a biexponential curve with a pattern similar to that reported for free ADM. The plasma concentration of drug circulating in liposome-associated from was also measured in a subgroup of seven patients. Liposome-associated drug was found to be rapidly cleared from plasma. Its ratio to non-liposome-associated drug appeared to correlate with liver reserve, with highest ratios in patients with normal liver function. Liposome clearance, as measured by the plasma concentration of PG in three patients was slower than the clearance of liposome-associated ADM, suggesting that liposomes lose part of their drug payload during circulation. To learn about the liposome organ distribution, imaging studies were carried out with 111Indium-deferoxamine labelled liposomes of the same composition. Liposomes were cleared predominantly by liver and spleen and to a lesser extent by bone marrow in seven out of nine patients. In two patients with active hepatitis and severe liver dysfunction, there was minimal liver uptake and increased spleen and bone marrow uptake. Except for one hepatoma patient, intrahepatic and extrahepatic tumours were not imaged by liposomes, suggesting that liposome uptake is restricted to cells of the reticulo-endothelial system (RES).(ABSTRACT TRUNCATED AT 250 WORDS)

Full text

PDF
1125

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amselem S., Gabizon A., Barenholz Y. Optimization and upscaling of doxorubicin-containing liposomes for clinical use. J Pharm Sci. 1990 Dec;79(12):1045–1052. doi: 10.1002/jps.2600791202. [DOI] [PubMed] [Google Scholar]
  2. Andrews P. A., Brenner D. E., Chou F. T., Kubo H., Bachur N. R. Facile and definitive determination of human adriamycin and daunoribicin metabolites by high-pressure liquid chromatography. Drug Metab Dispos. 1980 May-Jun;8(3):152–156. [PubMed] [Google Scholar]
  3. BARTLETT G. R. Phosphorus assay in column chromatography. J Biol Chem. 1959 Mar;234(3):466–468. [PubMed] [Google Scholar]
  4. Beijnen J. H., Rosing H., de Vries P. A., Underberg W. J. Stability of anthracycline antitumour agents in infusion fluids. J Parenter Sci Technol. 1985 Nov-Dec;39(6):220–222. [PubMed] [Google Scholar]
  5. Chlebowski R. T., Brzechwa-Adjukiewicz A., Cowden A., Block J. B., Tong M., Chan K. K. Doxorubicin (75 mg/m2) for hepatocellular carcinoma: clinical and pharmacokinetic results. Cancer Treat Rep. 1984 Mar;68(3):487–491. [PubMed] [Google Scholar]
  6. Cummings J., Smyth J. F. Pharmacology of adriamycin: the message to the clinician. Eur J Cancer Clin Oncol. 1988 Apr;24(4):579–582. doi: 10.1016/0277-5379(88)90283-0. [DOI] [PubMed] [Google Scholar]
  7. Druckmann S., Gabizon A., Barenholz Y. Separation of liposome-associated doxorubicin from non-liposome-associated doxorubicin in human plasma: implications for pharmacokinetic studies. Biochim Biophys Acta. 1989 Apr 28;980(3):381–384. doi: 10.1016/0005-2736(89)90329-5. [DOI] [PubMed] [Google Scholar]
  8. Eagan R. T., Fleming T. R., Schoonover V. Evaluation of response criteria in advanced lung cancer. Cancer. 1979 Sep;44(3):1125–1128. doi: 10.1002/1097-0142(197909)44:3<1125::aid-cncr2820440348>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]
  9. Eksborg S., Ehrsson H., Ekqvist B. Protein binding of anthraquinone glycosides, with special reference to adriamycin. Cancer Chemother Pharmacol. 1982 Dec;10(1):7–10. doi: 10.1007/BF00257228. [DOI] [PubMed] [Google Scholar]
  10. Essien H., Hwang K. J. Preparation of liposomes entrapping a high specific activity of 111In3+-bound inulin. Biochim Biophys Acta. 1988 Oct 20;944(3):329–336. doi: 10.1016/0005-2736(88)90502-0. [DOI] [PubMed] [Google Scholar]
  11. Gabizon A., Goren D., Fuks Z., Barenholz Y., Dagan A., Meshorer A. Enhancement of adriamycin delivery to liver metastatic cells with increased tumoricidal effect using liposomes as drug carriers. Cancer Res. 1983 Oct;43(10):4730–4735. [PubMed] [Google Scholar]
  12. Gabizon A., Goren D., Fuks Z., Meshorer A., Barenholz Y. Superior therapeutic activity of liposome-associated adriamycin in a murine metastatic tumour model. Br J Cancer. 1985 May;51(5):681–689. doi: 10.1038/bjc.1985.103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Gabizon A., Papahadjopoulos D. Liposome formulations with prolonged circulation time in blood and enhanced uptake by tumors. Proc Natl Acad Sci U S A. 1988 Sep;85(18):6949–6953. doi: 10.1073/pnas.85.18.6949. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Gabizon A., Peretz T., Sulkes A., Amselem S., Ben-Yosef R., Ben-Baruch N., Catane R., Biran S., Barenholz Y. Systemic administration of doxorubicin-containing liposomes in cancer patients: a phase I study. Eur J Cancer Clin Oncol. 1989 Dec;25(12):1795–1803. doi: 10.1016/0277-5379(89)90350-7. [DOI] [PubMed] [Google Scholar]
  15. Gabizon A., Shiota R., Papahadjopoulos D. Pharmacokinetics and tissue distribution of doxorubicin encapsulated in stable liposomes with long circulation times. J Natl Cancer Inst. 1989 Oct 4;81(19):1484–1488. doi: 10.1093/jnci/81.19.1484. [DOI] [PubMed] [Google Scholar]
  16. Goren D., Gabizon A., Barenholz Y. The influence of physical characteristics of liposomes containing doxorubicin on their pharmacological behavior. Biochim Biophys Acta. 1990 Nov 16;1029(2):285–294. doi: 10.1016/0005-2736(90)90165-k. [DOI] [PubMed] [Google Scholar]
  17. Greene R. F., Collins J. M., Jenkins J. F., Speyer J. L., Myers C. E. Plasma pharmacokinetics of adriamycin and adriamycinol: implications for the design of in vitro experiments and treatment protocols. Cancer Res. 1983 Jul;43(7):3417–3421. [PubMed] [Google Scholar]
  18. Mayhew E., Rustum Y., Vail W. J. Inhibition of liver metastases of M 5076 tumor by liposome-entrapped adriamycin. Cancer Drug Deliv. 1983;1(1):43–58. doi: 10.1089/cdd.1983.1.43. [DOI] [PubMed] [Google Scholar]
  19. Middleman E., Luce J., Frei E., 3rd Clinical trials with adriamycin. Cancer. 1971 Oct;28(4):844–850. doi: 10.1002/1097-0142(1971)28:4<844::aid-cncr2820280407>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  20. O'Bryan R. M., Luce J. K., Talley R. W., Gottlieb J. A., Baker L. H., Bonadonna G. Phase II evaluation of adriamycin in human neoplasia. Cancer. 1973 Jul;32(1):1–8. doi: 10.1002/1097-0142(197307)32:1<1::aid-cncr2820320101>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  21. Perez-Soler R. Liposomes as carriers of antitumor agents: toward a clinical reality. Cancer Treat Rev. 1989 Jun;16(2):67–82. doi: 10.1016/0305-7372(89)90011-x. [DOI] [PubMed] [Google Scholar]
  22. Rahman A., Treat J., Roh J. K., Potkul L. A., Alvord W. G., Forst D., Woolley P. V. A phase I clinical trial and pharmacokinetic evaluation of liposome-encapsulated doxorubicin. J Clin Oncol. 1990 Jun;8(6):1093–1100. doi: 10.1200/JCO.1990.8.6.1093. [DOI] [PubMed] [Google Scholar]
  23. Storm G., Roerdink F. H., Steerenberg P. A., de Jong W. H., Crommelin D. J. Influence of lipid composition on the antitumor activity exerted by doxorubicin-containing liposomes in a rat solid tumor model. Cancer Res. 1987 Jul 1;47(13):3366–3372. [PubMed] [Google Scholar]
  24. van de Velde C. J. The staging of hepatic metastases arising from colorectal cancer. Recent Results Cancer Res. 1986;100:85–90. doi: 10.1007/978-3-642-82635-1_11. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES