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  • 1
    ISSN: 1573-7373
    Keywords: gliomas ; intracarotid administration ; chemotherapy ; drug delivery ; toxicity ; neuropathology ; vascular pathology ; blood brain barrier ; carboplatin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract RMP-7 is a bradykinin B2 receptor agonist shown to permeabilize the blood-brain barrier, especially that associated with brain tumors, when administered via both intracarotid and intravenous routes. Both routes of administration are currently being tested in human trials in combination with the chemotherapeutic agent carboplatin as therapy for gliomas. As an essential prerequisite to the initial intracarotid clinical trials, the potential neurotoxicity of intra-arterial administration of RMP-7 (at a high or low dose), alone and in combination with carboplatin, was assessed in anesthetized Red Duroc swine. Five treatment groups were evaluated with each pig receiving a series of alternating, intra-arterial infusions of RMP-7 (or saline) followed by carboplatin (or saline), as follows: (1) vehicle control: saline/saline; (2) carboplatin only control: saline/carboplatin (50 mg total); (3) RMP-7 only control: RMP-7 (750 ng/kg)/saline; (4) low dose combination: RMP-7 (75 ng/kg)/carboplatin (50 mg total); and (5) high dose combination: RMP-7 (750 ng/kg)/carboplatin (50 mg total). For each subject, one of the alternating dosing sequences (above) was repeated four times during a single dosing session which lasted approximately 40 minutes. Assessments during the in-life phase of the study in the pre- and post-treatment periods consisted of heart rate, arterial blood pressure (systolic, diastolic, and mean), blood gases, body weight, general clinical observations (including evaluation for neurological deficit) and clinical pathology (including a comprehensive battery of standard blood coagulation, hematological and serum chemistry tests). In addition, during the time of treatment, heart rate and arterial blood pressure were monitored. The animals were terminated two weeks after dosing and the brain and rete mirabile (distal to site of infusion) were evaluated for gross and histopathological abnormalities. The histopathology analysis included a reader-blinded analysis using low and high power light microscopic examination of both H&E and Kluver-Berrera stained sections through several key cortical and subcortical brain regions. Transient decreases in arterial blood pressure (mean of 10–25 mmHg) were observed in both groups receiving the high dose of RMP-7 (i.e., 750 ng/kg). No other side effects attributable to RMP-7 and/or carboplatin were observed, and clinical observations revealed no evidence of neurologic deficits. Post-mortem examination revealed no evidence of CNS or cerebral vascular pathology attributable to carboplatin and RMP-7. This study demonstrates that intracarotid administration of the maximum tolerated dose of RMP-7 (750 ng/kg) alone, or in combination with carboplatin (50 mg) is not accompanied by any serious adverse effect, apparent cerebrovascular abnormality or neuropathologic consequence and offers further evidence for the safety of this novel therapeutic approach for enhancing delivery of chemotherapeutics to brain tumors.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-7373
    Keywords: blood-brain barrier ; bradykinin ; brain tumor ; carboplatin ; glucocorticoid ; RG2 glioma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A blood-tumor barrier (BTB) limits delivery of antitumoragents to brain tumors. This study sought todetermine whether dexamethasone (DXN) treatment of rats withintracranial gliomas would 1) further impair delivery ofcarboplatin to brain tumors, and 2) whether intracarotidinfusion of the bradykinin analog, RMP-7, would improvedelivery during concurrent DXN treatment. Wistar rats withRG2 gliomas were utilized and a unidirectional transport,Ki, of radiolabeled [14C] carboplatin was determined usingquantitative autoradiography. In DXN pretreatment animals, 3 mg/kg/dayof DXN was administered intraperitoneally for 3 daysprior to Ki determinations. At 10 days aftertumor implantation, Ki of [14C] carboplatin into DXN-treatedtumors and brain surrounding tumor (BST) was significantlylower compared to non-DXN treated tumors and BST(3.30 ± 0.91 vs. 4.47 ± 1.80, p〈 0.05, and 0.94 ± 0.84 vs. 2.18± 0.79, p 〈 0.05, respectively). Intracarotid infusionof RMP-7 (0.1 mg/kg/min) significantly increased the Kifor carboplatin in DXN-treated tumors (6.35 ± 3.10vs. 3.30 ± 0.91, p 〈 0.01), however, RMP-7increased Ki to a greater extent in tumorsnot pretreated with DXN (12.07 ± 3.60 vs.4.47 ± 1.80, p 〈 0.0001). Our studiesshow that dexamethasone decreases transport of carboplatin intobrain tumors. Intracarotid infusion of RMP-7 selectively increasescarboplatin transport to tumors.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-904X
    Keywords: blood-ocular barriers ; bradykinin ; drug delivery ; retina ; guinea pig
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Purpose. The ability of intravenous (i.v.) infusions of the bradykinin agonist, RMP-7, to permeabilize the blood-ocular barriers (BOB) to the antiviral agent ganciclovir was investigated in guinea-pigs. Methods. Different i.v. dosing regimens included pre-treatment with RMP-7 (0.2 μg/kg/min for 5 min) followed by either [3H]-ganciclovir (1 μCi/0.2 ml/min) alone, and/or co-infusion with RMP-7 and [3H]-ganciclovir. At specific times the animals were sacrificed, their eyes removed, and the retina and lens epithelium dissected and analyzed for the amount of radioactivity. Results. Using the ratio of tissue vs. integrated plasma radioactivity concentration, a two-fold increase in ganciclovir steady-state levels were observed in the retina as well as lens epithelium following RMP-7 pretreatment. Peak uptake effects were achieved with a 4.5 min ganciclovir infusion. Neither longer infusions of ganciclovir alone, nor co-infusions of RMP-7 and ganciclovir further enhanced the uptake effects. Kinetic analysis indicated that RMP-7 increased the rate of ganciclovir entry (K IN) in studied ocular tissues, while the efflux of drug (K OUT) was not affected by this treatment. Finally, ganciclovir retina:plasma ratios elevated by RMP-7 pre-treatment, remained higher than control ratios within 60 min following cessation of 4.5 min ganciclovir infusion. Conclusions. These data offer further evidence that BOB and in particular the blood-retinal barrier can be permeabilized via bradykinin receptor stimulation. As the i.v. infusions of RMP-7 enhanced the retinal uptake of ganciclovir, it is suggested that a combination of RMP-7 and ganciclovir may provide a novel approach for treating cytomegalo-virus retinis.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1573-904X
    Keywords: glioma ; sustained release ; microsphere ; carboplatin ; BCNU
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Purpose. Delivery of chemotherapeutics using implantable,biodegradable polymers provides a potentially powerful method of treating braintumors. The present studies examined the ability of injectablemicrospheres, formulated to release carboplatin or BCNU for 2–3 weeks,to enhance survival in a rodent model of deep, inoperable glioma. Methods. Rat glioma (RG2) cells were implanted into the striatum ofrats. In a first experiment, the tumors were allowed to grow for 3 days,followed by either no treatment, bolus chemotherapy (100 μg), orimplantation of microspheres containing 10, 50, or 100 μg ofcarboplatin. The microspheres were implanted, via hypodermic injection,directly into the center of the small, 3-day-old tumors. In a secondexperiment, tumors grew for 8 days prior to treatment with eithercarboplatin- or BCNU-loaded microspheres. The microspheres werethen injected either directly into the center of these larger tumors orinto three sites along the perimeter of the tumor. Separate sets ofanimals received bolus chemotherapy (100 μg) into either the tumorcenter or around the tumor perimeter. Results. Injection of carboplatin-loaded microspheres into the centerof the small 3 day old, tumors produced dose-related increases insurvival. When injections of carboplatin- or BCNU-loadedmicrospheres were made into the center of the larger, 8-day-old tumors,survival was not enhanced. However, when the microspheres wereinjected along the perimeter of the larger tumors, sustained-releasechemotherapy did significantly prolong survival. Bolus chemotherapywas less effective than sustained release chemotherapy. Conclusions. Together, these data: (1) demonstrate that sustaineddelivery of chemotherapy in or near the tumor site is superior toequipotent bolus doses in inoperable tumors, (2) demonstrate thatinjection of sustained release microspheres into the tissue surroundinga growing tumor may provide superior effects over injections directlyinto the tumor mass, and (3) suggest that this approach may providea useful means of selectively delivering chemotherapeutics to tumorsor portions of tumors that cannot otherwise be treated with conventionalsurgical approaches.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1573-904X
    Keywords: glioma ; sustained release ; microsphere ; carboplatin ; BCNU
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Purpose. Implantation of biodegradable polymers provides a powerfulmethod to deliver high, sustained concentrations of chemotherapeuticsto brain tumors. The present studies examined the ability of injectablepolymeric microspheres, formulated to release carboplatin or BCNUfor 2–3 weeks, to enhance survival in a rodent model ofsurgically-resected glioma. Methods. Rat glioma (RG2) cells were implanted into the cortex ofrats and allowed to grow for 10 days prior to surgical resection. Ratswere given either surgical resection only, bolus injection (100 μg) ormicrospheres containing 10, 50, or 100 μg of carboplatin or BCNU.The microspheres were implanted, via hypodermic injection, eitherdirectly into the surgical cavity or into the tissue along the perimeterof the cavity. Results. The order of survival among treatment groups was: noresection 〈 resection only 〈 bolus chemotherapy 〈 sustained releasechemotherapy. Carboplatin and BCNU did not differ in this respectand in each case, the enhanced survival achieved with sustained releasewas dose-related. However, the enhanced survival achieved withcarboplatin was substantially greater when the microspheres wereimplanted into the perimeter wall of the resection cavity, compared toimplantation into the cavity itself. The enhanced survival produced bycarboplatin implants along the resection perimeter was associated witha significant attenuation of regrowth of the tumor. Finally, in a separatestudy in non-tumor brain, atomic absorption spectrophotometryrevealed that while the microspheres produced significantly prolongedtissue levels of carboplatin relative to a bolus injection, carboplatindiffusion was limited to brain tissue extending primarily 0.5 mm fromthe injection site. Conclusions. These data demonstrate: (1) that sustained delivery ofchemotherapy is superior to equipotent bolus doses following tumorresection, and (2) that direct injection of sustained release microspheresinto the tissue surrounding a growing tumor mass may provide superioreffects over injections into the surgical cavity. They also suggest thatsuccessful implementation of this approach in humans may requiremeasures or circumstances that improve upon the limited spatial drugdiffusion from the implantation site.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1573-904X
    Keywords: blood-brain tumor barrier ; bradykinin ; brain metastases ; carboplatin ; carmustine ; paclitaxel ; vinorelbine ; gemcitabine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Purpose. The following experiments determined whether intravenous infusions of Cereport enhance delivery of chemotherapeutics and prolong survival in rats with metastatic tumors in the brain. Methods. Autoradiography and scintillation were used to examine uptake of the lipophilic (paclitaxel and carmustine) and the hydrophilic (carboplatin) chemotherapeutic agents, as well as the large hydrophilic marker, 70 kDa dextran. Cereport was also tested in combination with the chemotherapeutic drugs carboplatin, vinorelbine, gemcitabine and carmustine to determine if Cereport could enhance the survival benefit beyond that provided by chemotherapy alone. Results. Cereport enhanced the uptake of carboplatin and dextran, but not paclitaxel or carmustine. The pattern of Cereport's uptake effect with carboplatin revealed that Cereport selectively increased the proportion of highly permeable regions. Survival was significantly enhanced when Cereport was combined with either carboplatin, vinorelbine, or gemcitabine, but not carmustine, compared to each chemotherapeutic agent alone. Conclusions. These data provide the first evidence that Cereport, or any receptor-mediated approach intended to enhance the permeability of the blood-brain tumor barrier, can increase the delivery hydrophilic drugs to metastatic tumors in the brain, increasing survival in tumor-bearing rats.
    Type of Medium: Electronic Resource
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