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HPMA Copolymer-Conjugated Pirarubicin in Multimodal Treatment of a Patient with Stage IV Prostate Cancer and Extensive Lung and Bone Metastases

Dozono, Haruhiko
Author Dozono, Haruhiko Dozono Medical House, Kagoshima, Japan
Yanazume, Shintaro
Author Yanazume, Shintaro Department of Obstetrics and Gynecology, National Hospital Organization Kagoshima Medical Center, 8-1 Shiroyama, Kagoshima, 892-0853, Japan. s-yana@kagomc2.hosp.go.jp
Nakamura, Hideaki
Author Nakamura, Hideaki Institute of Drug Delivery Science, Sojo University, Ikeda 4-22-1, Nishi-ku, Kumamoto, 860-0082, Japan
Etrych, Tomáš
Author Etrych, Tomáš Institute of Macromolecular Chemistry, Academy of Sciences, Prague, Czech Republic
Chytil, Petr
Author Chytil, Petr Institute of Macromolecular Chemistry, Academy of Sciences, Prague, Czech Republic
Ulbrich, Karel
Author Ulbrich, Karel Institute of Macromolecular Chemistry, Academy of Sciences, Prague, Czech Republic
Fang, Jun
Author Fang, Jun Institute of Drug Delivery Science, Sojo University, Ikeda 4-22-1, Nishi-ku, Kumamoto, 860-0082, Japan
Arimura, Takeshi
Author Arimura, Takeshi Medipolis Proton Therapy and Research Center, Kagoshima, Japan
Douchi, Tsutomu
Author Douchi, Tsutomu Department of Obstetrics and Gynecology, Kagoshima University School of Medicine, Kagoshima, Japan
Kobayashi, Hiroaki
Author Kobayashi, Hiroaki Department of Obstetrics and Gynecology, Kagoshima University School of Medicine, Kagoshima, Japan
Ikoma, Michiaki
Author Ikoma, Michiaki Ikoma Urology Clinic, Kagoshima, Japan
Maeda, Hiroshi
Author Maeda, Hiroshi Institute of Drug Delivery Science, Sojo University, Ikeda 4-22-1, Nishi-ku, Kumamoto, 860-0082, Japan. hirmaeda@ph.sojo-u.ac.jp

Targeted oncology. 2016 Feb ; 11 (1) : 101-6.

Target Oncol
ISSN 1776-260X | 1776-2596
Source

Language English Country France Media print

Document type Case Reports, Journal Article, Research Support, Non-U.S. Gov't

Persistent link https://www.medvik.cz/link/pmid26194363

PubMed 26194363
DOI 10.1007/s11523-015-0379-4
PII: 10.1007/s11523-015-0379-4
Knihovny.cz E-resources

MeSH
Antineoplastic Agents therapeutic use MeSH
Doxorubicin analogs & derivatives therapeutic use MeSH
Combined Modality Therapy MeSH
Middle Aged MeSH
Humans MeSH
Methacrylates chemistry MeSH
Bone Neoplasms secondary therapy MeSH
Lung Neoplasms secondary therapy MeSH
Prostatic Neoplasms pathology therapy MeSH
Prognosis MeSH
Neoplasm Staging MeSH
Drug Delivery Systems * MeSH
Check Tag
Middle Aged MeSH
Humans MeSH
Male MeSH
Publication type
Journal Article MeSH
Case Reports MeSH
Research Support, Non-U.S. Gov't MeSH
Names of Substances
Antineoplastic Agents MeSH
Doxorubicin MeSH
hydroxypropyl methacrylate MeSH Browser
Methacrylates MeSH
pirarubicin MeSH Browser

Nanomedicine allows achievement of tumor-selective drug delivery because of the enhanced permeability and retention (EPR) effect of solid tumors. We report here the first clinical application of a new agent-HPMA copolymer-conjugated pirarubicin (P-THP)-with a molecular size of about 8 nm, or 38.5 kDa. A patient had advanced prostate cancer with multiple metastases in the lung, pelvis, femur, and perhaps the sacrum. In April 2013, this 60-year-old patient started treatment with leuprorelin and estradiol, which continued until July 2014, but the patient became refractory to this treatment. So the patient underwent proton beam radiotherapy targeted to the primary prostate cancer, and P-THP was administered for numerous metastatic tumor nodules concomitantly with radiotherapy. This combination therapy had remarkable results, with complete remission of multiple metastases in the lung and bone. The prostate-specific antigen (PSA) value was decreased from about 1000 ng/mL on April 30, 2013, to about 100 ng/mL on June 24, 2013, with hormone therapy, but rose again to 964.2 ng/mL and then to 1472 ng/mL in July 2013, during leuprorelin administration. P-THP treatment administered concomitantly with proton beam irradiation was started in August 2013. The PSA value was decreased to 102 ng/mL on August 26, 2013, and then to 0.971 ng/mL on October 8, 2013, and 0.277 ng/mL on January 15, 2015. The P-THP doses ranged from 30 to 75 mg of free THP equivalent/patient every 2-3 weeks without signs of serious toxicity, such as cardiovascular side effects or a reduction in quality of life. No evidence of relapse was found more than 20 months after P-THP administration. This case demonstrates the value of hydrazone-bonded polymeric drugs in multimodal therapy.

Department of Obstetrics and Gynecology Kagoshima University School of Medicine Kagoshima Japan

Department of Obstetrics and Gynecology National Hospital Organization Kagoshima Medical Center 8 1 Shiroyama Kagoshima 892 0853 Japan

Dozono Medical House Kagoshima Japan

Ikoma Urology Clinic Kagoshima Japan

Institute of Drug Delivery Science Sojo University Ikeda 4 22 1 Nishi ku Kumamoto 860 0082 Japan

Institute of Macromolecular Chemistry Academy of Sciences Prague Czech Republic

Medipolis Proton Therapy and Research Center Kagoshima Japan

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