Summary

Today, more than half of all cancer patients receive radiotherapy as part of their treatment. However, radiotherapy efficacy is often limited by healthy tissues toxicity and needs to be optimized. One relevant solution is to increase the radiation dose deposition from within the tumor cells. The presence of high atomic number (high-Z) elements within the X-ray pathway increases the probability of interaction with ionizing radiation as compared with tissues (composed of low-Z elements). Likewise, mammalian cells can handle materials at the nanoscale. Therefore, materials made of high-Z elements designed at the nanoscale can enhance the deposit of the radiation dose at the cancer cell level.

Still, the most relevant design of these nano-objects has been scarcely explored. Here, we hypothesize that the packing of high-Z elements within the nano-object is a key parameter when considering its design. We used gold and probe how its packing at the nanoscale can achieve the best probability of interaction with ionizing radiation. […]

Summary

Background: Functionalized hafnium oxide nanoparticles (NBTXR3) have been developed as selective radioenhancers, which may represent a breakthrough approach for the local treatment of solid tumors. The high electron density of the nanoparticles, when exposed to radiotherapy (RT), allow the absorption/deposition of a high radiation dose within the tumor cells, to physically kill the cells and possibly improve outcome. A phase I trial was implemented for the treatment of locally advanced HNSCC in patients (pts) older than 65 years who cannot receive cisplatin.

Methods: Pts received a single intratumor (IT) injection of NBTXR3, volume dose levels escalated at 5%, 10%, 15% and 22% of baseline tumor volume, followed by RT (IMRT, 70Gy/ 35 fractions / 7 weeks). Primary endpoints included feasibility of the IT implantation and safety. Secondary endpoints included IT residency of NBTXR3 using CT scan and RECIST 1.1 response.

Results: Enrollment was completed for volume 5%, 10%, and 15% (11 pts) and 1 patient at volume dose level 22%. Feasibility of the IT injection was confirmed. The treatment was easily administered, was safe with no SAE, or early DLT, which allowed the pts for completion of the planned RT schedule. Adverse events related to the injection procedure included grade 1-2 injection pain (1 pt), and tumor hemorrhage (1 pt). Results demonstrated that a single injection of NBTXR3 provides adequate bioavailability of NBTXR3 IT over seven weeks of RT. No leakage of NBTXR3 to the adjoining healthy tissues was observed. Preliminary results of antitumor activity according to RECIST 1.1 are presented below: 11 evaluable pts, 10 showed complete or partial response (RECIST 1.1) including, 1/5 complete response at dose levels ≤ 10% and 3/6 complete responses at dose levels > 10% Follow up results with duration of response and tolerance will be disclosed.

Conclusions: Injection of NBTXR3 was safe and well tolerated. All pts received the planned RT.

Summary

Most drugs are metabolized by hepatic cytochrome P450 3A4 (CYP3A4), resulting in their reduced bioavailability. In this study, we present the design and evaluation of biocompatible nanocarriers trapping a natural CYP3A4-inhibiting compound. Our aim in using nanocarriers was to target the natural CYP3A4-inhibiting agent to hepatic CYP3A4 and leave drug-metabolizing enzymes in other organs undisturbed. In the design of such nanocarriers, we took advantage of the nonspecific accumulation of small nanoparticles in the liver. Specific targeting functionalization was added to direct nanocarriers toward hepatocytes. Nanocarriers were evaluated in vitro for their CYP3A4 inhibition capacity and in vivo for their biodistribution, and finally injected 24 hours prior to the drug docetaxel, for their ability to improve the efficiency of the drug docetaxel. Nanoparticles of poly(lactic-co-glycolic) acid (PLGA) with a hydrodynamic diameter of 63 nm, functionalized with galactosamine, showed efficient in vitro CYP3A4 inhibition and the highest accumulation in hepatocytes. When compared to docetaxel alone, in nude mice bearing the human breast cancer, MDA-MB-231 model, they significantly improved the delay in tumor growth (treated group versus docetaxel alone, percent treated versus control ratio [%T/C] of 32%) and demonstrated a major improvement in overall survival (survival rate of 67% versus 0% at day 55).

Summary

Background: Functionalized hafnium oxide nanoparticles (NBTXR3) have been developed as selective radioenhancers, which may represent a breakthrough approach for the local treatment of solid tumors. This is a unique approach where crystalline nanomaterials with high electron density when exposed to radiotherapy, can allow penetrate into the cell and make feasible the absorption/deposition of a high energy dose within the tumor cell. A phase I/II trial was implemented in patients with locally advanced STS.

Methods: Patientsreceived a single intratumor (IT) injection of NBTXR3, volume escalated, followed by 50Gy RTx. Primary endpoints include feasibility of the IT implantation and safety. Secondary endpoints focus on efficacy such as pathological and RECIST response, IT residency of NBTXR3 over all the RTx period and operability. Results: Enrollment was completed for volume 1, 2, and 3 (15 pts). Feasibility of the IT injection was confirmed. The treatment was safe with no SAE, no early DLT and allowed the pts for completion of the planned RTx schedule. No grade 3-4 toxicity occurred, main grade 1-2 toxicities related to NBTXR3 were injection pain/reaction (4 pts), pyrexia (2 pts), abdominal pain (1 pt), pruritus (1 pt) and paresthesia (1 pt). Results demonstrated that a single injection of NBTXR3 provides adequate bioavailability of NBTXR3 IT over five weeks of radiotherapy. No leakage of NBTXR3 to the adjoining healthy tissues was observed. Further, NBTXR3 persistence was established by CT scan before surgery.

Conclusions: Injection of NBTXR3 was well tolerated. All pts received the planned radiotherapy (50 Gy/25 fractions/ 5 weeks) followed by wide surgical resection of the sarcoma. NBTXR3 with RTx showed a very good safety profile. Encouraging signs of antitumor activity were observed in different sarcoma subtypes, such as undifferentiated sarcoma, rhabdomyosarcoma, and synovial sarcoma, which constitutes a promising feature for this subset of pts whose primary tumor is locally advanced and has an important risk of relapse. Clinical trial information: NCT01433068.

Summary

Results & Conclusion: We created and developed NBTXR3 nanoparticles with a crystalline hafnium oxide core which provide high electron density structure and inert behavior in biological media. NBTXR3 nanoparticles’ characteristics, size, charge and shape, allow for efficient interaction with biological entities, cell membrane binding and cellular uptake. The nanoparticles were shown to form clusters at the subcellular level in tumor models. Of most importance, we show NBTXR3 intratumor bioavailability with dispersion of nanoparticles in the three dimensions and persistence within the tumor structure, supporting the use of NBTXR3 as effective antitumor therapeutic agent. Antitumor activity of NBTXR3 showed marked advantage in terms of survival, tumor specific growth delay and local control in A673 and HT1080 human tumor models. Changing radiotherapy benefit-risk ratio is challenging. These data are supportive for the first clinical development of hafnium oxide nanoparticles, with an on/off mode of action through successive fractions of radiation therapy using current equipment available in hospitals.

Summary

Photodynamic therapy in the elderly and heavily pretreated cancer patient populations may represent a promising therapeutical option in the management of malignant diseases provided that different approaches bring real improvement for its clinical application.

Silica-based nanocarrier encapsulating photosensitizers, the protoporphyrin IX (Pp IX), have been designed to improve the tumor bioavailability, to reduce photosensitizer accumulation in the skin and to differentially deliver the nanocarriers to cell organelles.

Pp IX silica-based nanocarriers were explored in in vitro and in vivo models with the ambition to improve knowledge on the role of biological factors in the photodamages. Some key features are presented here.