Patent Application
20230087252
The present invention relates to the field of therapeutic drugs and medicines for antitumor treatments.
More in detail, the present invention concerns an anti-tumoral compound for the localized treatment of neoplastic pathologies of malignant kind that cannot be excised by surgery, or with a high risk of local recurrence.
It is well known that in presence of neoplastic pathologies of malignant kind like, e.g., hepatocellular carcinoma, colorectal cancer or breast cancer, the removal of the tumoral mass is the only therapeutic treatment that guarantees the long term survival of the patient.
It is furthermore known that, at the light of the present medical knowledge, not all neoplastic pathologies of malignant kind may be removed by surgery, as said therapeutic method is tightly depending on the patient's clinical condition, on the localization of the neoplasias and on the morphologic features of the tumoral mass to be removed.
The removal of a neoplastic mass by surgical resection cannot be performed in the following cases:
Furthermore, the surgical removal of a tumoral mass cannot be performed without the certainty of obtaining a resection margin of healthy tissue of at least one centimetre from the infiltration limit of the tumoral cells, as it has been widely shown that resection margins less than one centimetre favour the recurrence of neoplastic pathologies of malignant kind in the original surgical site.
It is known that therapeutic methods alternative to surgical resection of a tumoral mass usually comprise:
It is further known that said methods have important and numerous limits or side effects, as:
Furthermore, none of said therapies proves to be radical for the purpose of allowing a long term survival of the patient.
In the pharmaceutical field, the method consisting in the inclusion of one or more active principles in a viscous material, functioning as a carrier of the same, for obtaining medical compounds allowing the localized treatment of different pathologies, is well known.
Among the many typologies of compounds that may be commonly obtained with said method, those with anti-inflammatory, antimicrobial, antihemorrhagic, dermoregenerating, analgesic, disinfectant and other action will be reported as an example.
Therefore, it is the aim of the present invention to obtain a compound for antitumor use that may be applied for the local treatment of neoplastic pathologies of malignant kind that cannot be surgically treated or showing a high risk of local recurrence by the inclusion, in a viscous material functioning as a carrier, of a substance having appropriate neoplastic capacities and functioning as a therapeutic agent.
It is furthermore the aim of the present invention to overcome some of the problems and of the limits deriving from the use of therapeutic methods commonly used for the treatment of neoplastic pathologies of malignant kind which cannot be treated surgically, or having a high risk of local recurrence.
The aim set forth is reached by means of an anti-tumoral compound, characterized in that it comprises:
According to a preferred embodiment of the present invention, the injectable biological glue is a haemostatic gel, or a hydrogel.
According to a further embodiment, the compound according to the present invention may comprise an antineoplastic substance with radiotherapy or chemotherapy effect.
A process for the production of said anti-tumoral compound is also the object of the present invention.
The compound according to the present invention has many and important advantages:
The anti-tumoral compound according to the present invention is based, as said before, on the principle if including a substance with suitable antineoplastic capacities into a special material with a viscous structure, arranged for functioning as a carrier for said substance.
Special biocompatible microspheres have been labelled with a radioactive high energy isotope for therapeutic use, then including the radiolabelled microspheres into a quick solidification haemostatic gel, thus obtaining a compound for antitumor action that may be directly inoculable inside tumoral masses that cannot be surgically treated, or that may be applied as a filling material in surgical wounds deriving from surgical resection of said tumoral masses.
Actually, histologic examinations have shown that said compound induces a favourable necrosis of the neoplastic cells in the area corresponding to inoculation into the tumoral mass of interest, or near the application area in the wound deriving from surgical resection of said tumoral mass. The necrosis of the tumoral cells of interest is induced by means of an appropriate internal radiotherapy with electrons (IRE), determined by the localized emission of radioactive particles by said radiolabelled microspheres.
Laboratory examinations, carried out in a gamma camera and with PET/CT, have surprisingly shown that the compound spreads in an almost homogeneous manner inside the tumoral mass into which it has been inoculated, or inside the surgical wound onto which it has been applied, due to the viscous structure of the haemostatic gel forming the matrix thereof, and that such homogeneous diffusion is highly functional to the necrosis of the neoplastic cells localized in such areas.
The same examinations have also surprisingly shown that, if a haemostatic gel with a sufficient solidification speed is used as a carrier of said radiolabelled microspheres, the possible dispersion of said microspheres in the patient's body—potentially deriving from factors like gravity, their diffusion in the blood and/or lymphatic vessels, the presence of serosanguineous collections and other—is strongly limited, consequently avoiding any possible side effect deriving from possible dispersion of radioactive material in the patient himself.
Finally, further laboratory examinations have shown that the dispersion of the radiolabelled microspheres in the patient's body may be further limited including a substance in the compound arranged for determining a temporary vasoconstriction of the tissues surrounding the inoculation or application point of the same.
According to the present invention, and in a not restrictive exemplification, an anti-tumoral compound for local use according to the present invention mainly consists of:
According to the present invention, above described anti-tumoral compound is arranged for being directly inoculated into tumoral masses of malignant kind that cannot be surgically treated, for determining the complete necrosis of the neoplastic cells that are near the inoculation point thereof.
It is also arranged for being applied as a filling material in surgical wounds deriving from surgical resection, or from ablative treatments, of tumoral masses of malignant kind, for determining the complete necrosis of possible residual neoplastic cells along the edges of the wounds, so that said edges are surrounded by at least one centimetre of healthy tissue thus reducing the risk of a possible recurrence of the neoplasia in the original site.
Said anti-tumoral compound induces the complete necrosis of the neoplastic cells near its inoculation or application point by means of an adequate internal radiotherapy with electrons (IRE) determined by the localized emission of radioactive particles by the radiolabelled microspheres comprised in the haemostatic gel forming the matrix thereof. Moreover, the complete necrosis of the neoplastic cells is favoured by the homogeneous distribution of the compound inside the tumoral mass into which it is inoculated or inside the surgical wound onto which it is applied, which is made possible due to the viscosity of the haemostatic gel forming the matrix thereof.
Evidence of the homogeneous distribution of the compound in cavity is given in enclosed
Such figures also show that the anti-tumoral compound does not reveal any dissociation between the solutions and the solidified gel, and that said gel does not reveal alterations of its distribution and of its solidification near the cavity of interest.
The quick solidification of the haemostatic gel, forming the matrix of the anti-tumoral compound, determines the confinement of the radiolabelled microspheres inside the inoculation or application site of said compound, advantageously producing a prolongation of its administration time and a consequent increase of its local dosage, deriving from the strong concentration of said microspheres inside each single tumoral mass, or of each single surgery wound treated.
The quick solidification of said haemostatic gel also limits the dispersion of the radiolabelled microspheres in the patient's body, potentially caused by factors like the gravity, the diffusion in blood and lymphatic vessels, the presence of serosanguineous collections and other, consequently avoiding the setting in of common side effects due to the dispersion of radioactive material in the patient himself.
Said haemostatic gel is obtained by the local injection of a couple of distinct chemical solutions, according to appropriate ratios, one of which fibrinogen and aprotinin-based, with a dosage of 1 ml, and the other one thrombin and calcium chloride-based, with a dosage of 0.75 ml.
The injection of the two chemical solutions forming said haemostatic gel by means of a coaxial catheter with double lumen, e.g. of the kind disclosed in patent application ITMI2009A000969 of 3 Jun. 2009.
Said gel comprises a solution of biocompatible microspheres labelled with a radioactive isotope for therapeutic use, characterized in the emission of high energy electrons and with a penetration power in the tissue>5 mm, equal to 500-625 cellular layers, and preferably represented by the yttrium radioactive isotope (90Y).
With a dosage of 0.25 ml, said solution allows to include inside said haemostatic gel a quantity of biocompatible microspheres equal to 30-60.times.10.sup.6 with a diameter comprised between 20 and 60 micron and labelled with the radioactive yttrium isotope (90Y), having an average life of 64.1 hours and a tissue penetration coefficient of 11 mm, with an average penetration of the same of 2.5 mm, such as to determine the complete necrosis of the cancer tissues surrounding the inoculation or application area of the examined anti-tumoral compound.
Said microspheres, which are unassimilable by the human body, release 94% of the radioactivity of the yttrium isotope (90Y) contained therein, in a time period superior to the average physical and biological life of said isotope, evaluated in 10-13 days from the moment of inoculation or application of said anti-tumoral compound.
The data shown in the graphs in
Following table 1, on the other hand, reports the results of the measurements of the radiation dosage absorbed by wounds of different dimension, with the reference radius respectively equal to 0.5 cm, 1 cm and 1.5 cm.
The results of the measurements, and of the processing deriving therefrom, confirm the strong concentration of the radiotherapy action of the radiolabelled microspheres near the inoculation or application point of the examined anti-tumoral compound.
Besides, the results confirm the limited dispersion of radioactive elements in the areas around the inoculation or application point of said compound, and consequently their limited dispersion in the patient's body.
As an alternative to above mentioned biocompatible microspheres, common antineoplastic substances with chemotherapy action may be comprised inside said haemostatic gel forming the matrix of said anti-tumoral compound.
Furthermore, an epinephrine solution is included inside said haemostatic gel, with a dosage equal to 0.1 ml/mg, arranged for determining a temporary vasoconstriction of the tissues around the inoculation or application area of the compound.
Said solution determines an advantageous increase of the haemostatic effect already given by the gel forming the matrix of said compound and, strongly reducing the bleeding of the tissues treated, it further limits the dispersion of the antineoplastic substances in the patient's body and thus avoids the arising of common side effects deriving from the systemic exposure to the toxic components of the same.
The particular features of the anti-tumoral compound above described, like the highly localized administration and the limited dispersion of the antineoplastic substances contained therein, allow an advantageous use of said compound in the field of the therapeutic treatment of tumoral masses localized in the area of the head and in the brain tissues, in the area of the neck, of the chest cavity, of the abdominal cavity and in the area of the retroperitoneal space, in the area of the pelvis as well as in the bones and in the soft tissues in general.
Said features also allow the use of said compound as an independent therapeutic treatment, suitable for allowing the treatment of tumoral masses that cannot be surgically removed, or as a therapeutic treatment complementary to surgical resection, or to alternative surgical techniques, suitable for maximizing the efficiency of those therapies and reducing the risk of neoplastic recurrences in the original site.
Best results have been obtained, with respect to similar substances, with the use of TISSUCOL (BAXTER) or Beriplast P (Nycomed), as a biological glue of SIR (SIRTeX) spheres as biocompatible microsphere solution; and of epinephrine (adrenaline) belonging to the adrenergic activity catecholamines of A and B type, as a local vasoconstrictor agent on the smooth muscles.
Best results have been obtained also with the use of the biological glue Coseal (BAXTER), a surgical sealant resulting from the localized injection of two different synthetic polyethylene glycols (PEGs), of a diluted solution of hydrochloric acid and of a solution of sodium phosphate/sodium carbonate.
During administration, said polyethylene glycols and said solutions form a hydrogel that adheres to the tissues and covalently binds itself to the same.
The pharmacologic behaviour of the anti-tumoral compound according to the present invention has been examined in different species, making use of animals with spontaneous or implanted neoplasias.
The results of said studies have shown—in imaging mode—that following to the administration of the compound in the wound, no loss of radiolabelled microspheres occurs in the tissues around the area of its inoculation or application.
By means of autoradiography it has been proved, in particular, that the dose injected in the tested animals remains active inside the solidified gel until 13 days after its injection.
Histological examination in a number of pigs has shown the necrosis of all neoplastic cells comprised in the area of administration of the anti-tumoral compound and said area varies between 0.6 and 3.2 mm.
The dose given to the animals has been considered tumoricidal for wounds between 3 and 22 cc, and no radioactivity has been found in the blood of the same.
Besides, different dosages of yttrium radioactive isotope (90Y) have been evaluated, according to the volume of the residual surgical cavity to be filled up or to the dimensions of the wound to be treated, as appropriately summed up in following Table 2.
The precondition for the dosimetric evaluation is that the yttrium radioactive isotope (90Y) is homogeneously distributed inside the residual surgical cavity and inside the solidified gel forming the matrix of said compound, obtained through the co-injection of TISSUCOL (BAXTER), or Beriplast P (Nycomed), and epinephrine.
The different components of the haemostatic gel forming the matrix of the anti-tumoral compound have been given through a 2.5 ml syringe by means of a slow infusion carried out through a special coaxial catheter with double lumen.
The ratio between the fibrinogen-aprotinin solution, the thrombin-calcium chloride solution and the microsphere SIR solution was respectively of 1 ml: 0.75 ml: 0.25 ml.
In this preparation, the activity of the yttrium radioactive isotope (90Y) has been of 22 MBq (0.6 mCi).
The exposure of the staff to the components of the compound has been evaluated by means of a dosimetric thermoluminescence detector (TDL), because the preparation and the administration procedure of the compound must be considered as potentially dangerous.
Such exposure has been estimated supposing to manage a 3 GBq device with a time for preparing the dose of 30 minutes (for technical staff) and suggesting an average dose of 2 GBq in the patients and a time for the injection of the dose of 20 minutes (for medical staff).
During work, the detector has been placed near the pelvis, on the collar of the T-shirt and on the fingers.
The results are summed up in following table 3.
In a non-limiting example, the production process of the anti-tumoral compound according to the present invention comprises:
In a possible embodiment, the process for the production of said anti-tumoral compound comprises:
As an alternative, the phase of adding the compounds, common to both described procedures, and carried out with a solution of biocompatible microspheres labelled with a high energy isotope for therapeutic use, may be replaced by a phase of adding chemotherapy drugs.
This application is a continuation of U.S. application Ser. No. 14/351,606, filed Apr. 14, 2014, which is a National Phase application of PCT/IT2011/000354, filed Oct. 21, 2011.
| Number | Date | Country | |
|---|---|---|---|
| Parent | 14351606 | Apr 2014 | US |
| Child | 17668272 | US |
