A single microbubble formulation carrying 5-fluorouridine, Irinotecan and oxaliplatin to enable FOLFIRINOX treatment of pancreatic and colon cancer using ultrasound targeted microbubble destruction

Jinhui Gao, Keiran Logan, Heather Nesbitt, Bridgeen Callan, Thomas McKaig, Mark Taylor, Mark Love, Anthony P. McHale, D Griffith, J Callan

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Abstract

FOLFIRINOX and FOLFOXIRI are combination chemotherapy treatments that incorporate the same drug cocktail (folinic acid, 5-fluorouracil, oxaliplatin and irinotecan) but exploit an altered dosing regimen when used in the management of pancreatic and colorectal cancer, respectively. Both have proven effective in extending life when used to treat patients with metastatic disease but are accompanied by significant adverse effects. To facilitate improved tumour-targeting of this drug combination, an ultrasound responsive microbubble formulation loaded with 5-fluorouridine, irinotecan and oxaliplatin (FIRINOX MB) was developed and its efficacy tested, together with the non-toxic folinic acid, in preclinical murine models of pancreatic and colorectal cancer. A significant
improvement in tumour growth delay was observed in both models following ultrasound targeted microbubble destruction (UTMD) mediated FIRINOX treatment with pancreatic tumours 189% and colorectal tumours 82% smaller at the conclusion of the study when compared to animals treated with a standard dose of FOLFIRINOX. Survival prospects were also improved for animals in the UTMD mediated FIRINOX treatment group with an average survival of 22.17 ± 12.19 days (pancreatic) and 44.40 ± 3.85 days (colorectal) compared to standard FOLFIRINOX treatment (15.83 ± 4.17 days(pancreatic) and 37.50 ± 7.72 days (colon)). Notably, this improved efficacy was achieved using FIRINOX MB that contained 5-fluorouricil, irinotecan and oxaliplatin loadings that were 13.44-fold, 9.19-fold and 1.53-fold lower than used for the standard FOLFIRINOX treatment. These results suggest that UTMD enhances delivery of FIRINOX chemotherapy, making it significantly more effective at a substantially lower dose. In addition, the reduced systemic levels of 5-fluorouracil, irinotecan and oxaliplatin should also make the treatment more tolerable and reduce the adverse effects often associated with this treatment.
Original languageEnglish
Pages (from-to)358-366
Number of pages9
JournalJournal of Controlled Release
Volume338
Early online date1 Sept 2021
DOIs
Publication statusPublished (in print/issue) - 10 Oct 2021

Bibliographical note

Funding Information:
JFC thanks Norbrook Laboratories Ltd. for an endowed chair and Mrs. Margaret McGowan for a charitable donation toward this research. DMG gratefully acknowledges funding received from the Synthesis and Solid State Pharmaceutical Centre (SSPC), financed by a research grant from Science Foundation Ireland (SFI) and co-funded under the European Regional Development Fund under Grant Number 12/RC/2275_P2 . DMG thanks Dr. Diego Montagner (Maynooth University) for kindly running the 195 Pt NMR sample.

Funding Information:
JFC thanks Norbrook Laboratories Ltd. for an endowed chair and Mrs. Margaret McGowan for a charitable donation toward this research. DMG gratefully acknowledges funding received from the Synthesis and Solid State Pharmaceutical Centre (SSPC), financed by a research grant from Science Foundation Ireland (SFI) and co-funded under the European Regional Development Fund under Grant Number 12/RC/2275_P2. DMG thanks Dr. Diego Montagner (Maynooth University) for kindly running the 195Pt NMR sample.

Publisher Copyright:
© 2021

Keywords

  • FOLFIRINOX
  • FOLFOXIRI
  • Microbubbles
  • ultrasound
  • pancreatic cancer
  • colorectal cancer
  • Pancreatic cancer
  • Colorectal cancer
  • Ultrasound
  • Humans
  • Antineoplastic Combined Chemotherapy Protocols
  • Treatment Outcome
  • Camptothecin/therapeutic use
  • Fluorouracil/therapeutic use
  • Irinotecan
  • Animals
  • Oxaliplatin
  • Uridine/analogs & derivatives
  • Mice
  • Pancreatic Neoplasms/drug therapy
  • Colonic Neoplasms/drug therapy
  • Leucovorin/therapeutic use

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