Synergistic antitumor activity of the SN-38-incorporating polymeric micelles NK012 with S-1 in a mouse model of non-small cell lung cancer

Int J Cancer. 2010 Dec 1;127(11):2699-706. doi: 10.1002/ijc.25282.

Abstract

The combination therapy of CPT-11, a prodrug of SN-38, with S-1, a dihydropyrimidine dehydrogenase inhibitory fluoropyrimidine, shows a high clinical response rate in non-small cell lung cancer (NSCLC). However, this combination causes severe toxicities such as diarrhea. Here, we investigated the advantages of treatment with the SN-38-incorporating polymeric micelles NK012 over CPT-11 in combination with S-1 in mice bearing a NSCLC xenograft in terms of antitumor activity and toxic effects, particularly intestinal toxicity. In vitro cytotoxic effects were examined in human NSCLC cell lines (A549, PC-9, PC-14, EBC-1 and H520). In vivo antitumor effects were evaluated in PC-14- and EBC-1-bearing mice after NK012 or CPT-11 administration on Days 0 and 7 and S-1 administration on Days 0-13. Pathological changes in the small intestine were also investigated. The in vitro growth inhibitory effects of NK012 were 56.8- to 622-fold more potent than those of CPT-11. NK012/S-1 treatment showed significantly higher antitumor activity both in PC-14-bearing (p = 0.0007) and EBC-1-bearing mice (p < 0.0001) than CPT-11/S-1 treatment. The deformity and decrease in the density of intestinal villi were more severe in CPT-11/S-1-treated mice than in NK012/S-1-treated mice. NK012/S-1 combination is a promising candidate regimen against NSCLC without inducing toxicities such as severe diarrhea and therefore warrants clinical evaluation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / chemistry
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology*
  • Antineoplastic Combined Chemotherapy Protocols / toxicity
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives*
  • Camptothecin / chemistry
  • Camptothecin / pharmacology
  • Camptothecin / toxicity
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / enzymology
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Cell Line, Tumor
  • Dihydrouracil Dehydrogenase (NADP) / biosynthesis
  • Dihydrouracil Dehydrogenase (NADP) / genetics
  • Drug Combinations
  • Drug Delivery Systems
  • Drug Synergism
  • Female
  • Humans
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / pathology
  • Irinotecan
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / enzymology
  • Lung Neoplasms / genetics
  • Mice
  • Mice, Inbred BALB C
  • Mice, Nude
  • Micelles
  • Oxonic Acid / administration & dosage
  • Oxonic Acid / chemistry
  • Oxonic Acid / pharmacology*
  • Oxonic Acid / toxicity
  • RNA, Messenger / biosynthesis
  • RNA, Messenger / genetics
  • Tegafur / administration & dosage
  • Tegafur / chemistry
  • Tegafur / pharmacology*
  • Tegafur / toxicity
  • Thymidylate Synthase / biosynthesis
  • Thymidylate Synthase / genetics
  • Xenograft Model Antitumor Assays

Substances

  • Drug Combinations
  • Micelles
  • RNA, Messenger
  • S 1 (combination)
  • Tegafur
  • Oxonic Acid
  • Irinotecan
  • Dihydrouracil Dehydrogenase (NADP)
  • Thymidylate Synthase
  • Camptothecin