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      Pharmacokinetic profile of paclitaxel in the plasma, lung, and diaphragm following intravenous or intrapleural administration in rats

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          Abstract

          Background

          The optimal chemotherapy route for non-small cell lung cancers involving the phrenic nerve and diaphragm is unclear. The pharmacokinetic properties of paclitaxel following intravenous (IV) or intrapleural (IP) administration were analyzed in the plasma, lung, and diaphragm in a rat model. The purpose of this study was to determine whether IP injection increased paclitaxel concentration in the diaphragm.

          Methods

          Paclitaxel was administered by IV or IP to male Sprague-Dawley rats. The concentration of drug in the plasma, lung, and diaphragm was determined using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The pharmacokinetic parameters area under the curve (AUC), mean residence time (MRT), peak plasma concentration (C max), and half-life (t 1/2) were analyzed.

          Results

          Paclitaxel concentration in the plasma, lung, and diaphragm decreased quickly following IV administration. However, after IP injection, paclitaxel reached a high concentration in the plasma, lung, and diaphragm that declined gradually. Significant differences in all parameters, except C max in the lung, were observed between the two routes of administration (all P < 0.05). Plasma exposure to paclitaxel IP was 41.1% of that observed after IV in the first 24 hours ( P < 0.05). IP also significantly increased exposure of paclitaxel in comparison with IV administration to 267.3% and 905.7% of IV administration in the lung and diaphragm, respectively ( P < 0.05).

          Conclusion

          These results suggest that IP administration may reduce systemic distribution of paclitaxel and increase the concentration in the lung and diaphragm. This could increase therapeutic efficacy by increasing the available drug and reduce systemic toxicity.

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          Most cited references19

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          The use of body surface area as a criterion of drug dosage in cancer chemotherapy.

          D. Pinkel (1958)
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            Japanese Lung Cancer Registry Study: first prospective enrollment of a large number of surgical and nonsurgical cases in 2002.

            To investigate prognoses of lung cancer patients prospectively enrolled in the Japan Lung Cancer Registry Study. Patients newly diagnosed as having lung cancer exclusively in 2002 were enrolled. Follow-up surveys were performed twice, in 2004 and 2009, and the final follow-up data with prognoses were analyzed for 14,695 patients (79%). Clinical stages were defined according to the sixth edition of the International Union Against Cancer--tumor, node, metastasis classification (2002). The mean age was 67.1 years (range, 18-89 years), and there were 10,194 men (69.3%) and 4315 women (29.7%). The most frequent histology was adenocarcinoma (n = 8325, 56.7%), followed by squamous cell carcinoma (n = 3778, 26%) and small cell carcinoma (n = 1345, 9.2%). The distribution of clinical stages was as follows: IA, 4245 cases (29.3%); IB, 2248 (14.5%); IIA, 208 (1.4%); IIB, 918 (6.3%); IIIA, 1700 (11.8%); IIIB, 2110 (16.3%); and IV, 3037 (21.0%). The 5-year survival rates were 44.3% for all patients, 46.8% for those with non-small cell lung cancer, and 14.7% for those with small cell lung cancer. According to the clinical stage of non-small cell lung cancer and small cell lung cancer, the 5-year survival rates were 79.4 and 52.7% for stage IA, 56.9 and 39.3% for IB, 49.0 and 31.7% for IIA, 42.3 and 29.9% for IIB, 30.9 and 17.2% for IIIA, 16.7 and 12.4% for IIIB, and 5.8 and 3.8% for IV, respectively. Analysis of a large cohort in the Japanese registry study found that stage-specific prognosis was within a range similar to other reports. The data presented should provide an important reference for future clinical trials in Japan.
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              Coadministration of epithelial junction opener JO-1 improves the efficacy and safety of chemotherapeutic drugs.

              Epithelial junctions between tumor cells inhibit the penetration of anticancer drugs into tumors. We previously reported on recombinant adenovirus serotype 3-derived protein (JO-1), which triggers transient opening of intercellular junctions in epithelial tumors through binding to desmoglein 2 (DSG2), and enhances the antitumor effects of several therapeutic monoclonal antibodies. The goal of this study was to evaluate whether JO-1 cotherapy can also improve the efficacy of chemotherapeutic drugs. The effect of intravenous application of JO-1 in combination with several chemotherapy drugs, including paclitaxel/Taxol, nanoparticle albumin-bound paclitaxel/Abraxane, liposomal doxorubicin/Doxil, and irinotecan/Camptosar, was tested in xenograft models for breast, colon, ovarian, gastric and lung cancer. Because JO-1 does not bind to mouse cells, for safety studies with JO-1, we also used human DSG2 (hDSG2) transgenic mice with tumors that overexpressed hDSG2. JO-1 increased the efficacy of chemotherapeutic drugs, and in several models overcame drug resistance. JO-1 treatment also allowed for the reduction of drug doses required to achieve antitumor effects. Importantly, JO-1 coadmininstration protected normal tissues, including bone marrow and intestinal epithelium, against toxic effects that are normally associated with chemotherapeutic agents. Using the hDSG2-transgenic mouse model, we showed that JO-1 predominantly accumulates in tumors. Except for a mild, transient diarrhea, intravenous injection of JO-1 (2 mg/kg) had no critical side effects on other tissues or hematologic parameters in hDSG2-transgenic mice. Our preliminary data suggest that JO-1 cotherapy has the potential to improve the therapeutic outcome of cancer chemotherapy. ©2012 AACR.
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                Author and article information

                Journal
                Thorac Cancer
                Thorac Cancer
                tca
                Thoracic Cancer
                BlackWell Publishing Ltd (Oxford, UK )
                1759-7706
                1759-7714
                January 2015
                07 January 2015
                : 6
                : 1
                : 43-48
                Affiliations
                [1 ]Department of Chest Surgery, The General Hospital of The People's Liberation Army Beijing, China
                [2 ]Department of Cardio-thoracic Surgery, First Affiliated Hospital, General Hospital of PLA Beijing, China
                Author notes
                Correspondence, Changhai Yu, Department of Cardio-thoracic Surgery, First Affiliated Hospital, General Hospital of PLA, Beijing 100048, China., Tel: +86 1066848368, Fax: +86 1066848368, Email: xxwk304@ 123456163.com

                Jie Li and Jian Tang contributed equally to this work.

                Article
                10.1111/1759-7714.12139
                4448465
                35050445-3793-4d73-9829-36751e66951e
                © 2014 The Authors. Thoracic Cancer published by Tianjin Lung Cancer Institute and Wiley Publishing Asia Pty Ltd.

                This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 15 April 2014
                : 12 May 2014
                Categories
                Original Articles

                diaphragm,intrapleural administration,lung,paclitaxel,plasma

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