ALEJANDRO SOSNIK
5.5 Translation into Clinics and Perspectives
The great potential of polymeric micelles to encapsulate, release and target drugs and the profuse investigations conducted in the field have led to a rich intellectual property.16 However, only a few stimuli-responsive micellar systems have reached the clinical phase. Most of these copolymers combine PEG with pAsp, PLA and PPO and exploit the EPR effect to passively target antitumorals and to overcome multi-drug resistance upon intravenous administration (Table 5.2).270 On the other hand, owing to (i) the great chemical and architectural versatility, (ii) the good encapsulation capacity and (iii) the relatively high physical stability with respect to conventional surfactant micelles, more recent studies have explored their potential administration by alternative routes such as oral, ocular and intra-nasal.
Undoubtedly, cancer has led and pushed the nanomedicine research forward.
However, the lessons learnt from the extensive experience gained in this field have contributed to envisage the potential translation of these technology platforms for the treatment of infectious diseases like HIV, tuberculose and viral hepatitis. Products for the treatment of cancer are the only ones undergoing more advanced clinical trials and they could become the first approved medicines employing this kind of nanocarrier. In this context, the near future will be decisive to realize the real potential of polymeric micelles.
Temperature- and pH-sensitive Polymeric Micelles for Drug Encapsulation 135
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Table 5.2 Micellar delivery systems under clinical evaluation.
Product Amphiphile
Encapsulated
drug Goal Phase (Country) Company
NK911 Doxorubicin Targeting by EPR effect I for pancreatic,
colorectal,
leiomyosarcoma, gastric, esophageal and gall bladder
Nippon Kayaku Co., Japan
NK012 SN-38 (active
metabolite of irinotecan)
II for breast cancer (USA)
NK105 PEG-pAsp Paclitaxel II for stomach cancer
(Japan)
I for breast cancer (Japan)
NanoCarrier Co., Japan
NC-6004 (Nanoplatins)
Coordination bonds of drug with PEG- polyaminoacid copolymer
Cisplatin Targeting by EPR effect and reduced nephro- and neurotoxicity
II for pancreatic cancer (Asia)
NC-4016 Coordination bonds of drug with PEG- polyaminoacid copolymer
Oxaliplatin Targeting by EPR effect and reduced neuropathy
I for solid cancer (EU)
Genexol-PM PEG-PLA Paclitaxel Solubilization and
reduction of Cremophor EL toxicity
Targeting by EPR effect
II for breast and lung cancer (USA, Korea) IIa for pancreatic cancer
(USA)
Samyang Co., Korea
SP-1049Ca Mixed poloxamer micelles
Doxorubicin Functional inhibition of Pgp efflux pump
II for esophageal and gastroesophageal cancer (USA)
Supratek Pharma Inc., Canada Efavirenz
pediatric aqueous solution
Poloxamer micelles Efavirenz Bioavailability improvement
Easy dose adjustment and greater patient
compliance
Reduced inter- and intra- individual variability
Comparative
bioavailability study with standard capsule
Faculty of Pharmacy and Biochemistry, University of Buenos Aires
aSP-1049C was granted orphan drug designation for the treatment of gastric cancer in 2008.
136Chapter5
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Acknowledgements
A. Sosnik is a staff member of CONICET and thanks the support of the
‘‘Iberoamerican network of new materials for the design of advanced drug- delivery systems in diseases of high socioeconomic impact’’
(RIMADEL-CYTED).
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Ultrasound-triggered Release from Micelles
WILLIAM G. PITT,*
aGHALEB A. HUSSEINI
bAND LAURA N. KHERBECK
baChemical Engineering Department, Brigham Young University, Provo, UT84602, USA;bAmerican University of Sharjah, Sharjah, UAE
*Email: [email protected]