Determination of plasma concentrations of epirubicin and its metabolites by high-performance liquid chromatography during a 96-h infusion in cancer chemotherapy

In order to determine epirubicin and its metabolites at low concentrations (<38 ng/ml) in small plasma samples, a fast reliable method based on a precipitation pre-treatment and sensitive reversed-phase isocratic HPLC has been developed and validated for epirubicin in the range 5–100 ng/ml. The R.S.D. was 5–9% over this concentration range. For human serum containing 25 ng/ml of epirubicin, the inter- and intra-day variation was <10%. Recoveries of the metabolites epirubicinol, 7-deoxydoxorubicinone and 7-deoxydoxorubicinolone at 20 ng/ml ranged from 94–104%. The assay has been used to study human plasma samples taken during a 96-h infusion of epirubicin in a patient with multiple myeloma. The combined levels of the unseparated metabolites, epirubicin glucuronide and epirubicinol glucuronide, were semiquantitatively determined after treatment with β-glucuronidase. The metabolites epirubicinol and 7-deoxydoxorubicinolone, but not 7-deoxydoxorubicinone, were also detected and measured.     

Simultaneous determination of epirubicin, doxorubicin and their principal metabolites in human plasma by high-performance liquid chromatography and electrochemical detection

A high-performance liquid chromatographic method with electrochemical detection has been developed for the simultaneous determination of epirubicin, 13-S-dihydroepirubicin, doxorubicin and 13-S-dihydrodoxorubicin in human plasma. An aliquot of 200 μl plasma, spiked with internal standard, was extracted by solid-phase extraction using polymeric adsorbent columns. Chromatography was performed using a C₁₈ reversed-phase column with a mobile phase consisting of water–acetonitrile (71:29, v/v) containing 0.05 M Na₂HPO₄ and 0.05% v/v triethylamine adjusted to pH 4.6 with citric acid. Linearity of the method was obtained in the concentration range of 1–500 ng/ml for all the analytes. Analytical recoveries of the analytes ranged from 89 to 93%. The assay can be used for the simultaneous determination of the four analytes, or for epirubicin and its metabolite or doxorubicin and its metabolite, using the other parent drug as an internal standard. The method was applied to analyze human plasma samples from patients treated with epirubicin using doxorubicin as an internal standard.     

表柔比星化疗对乳腺癌转移潜能的影响

目的:比较乳腺癌细胞经过表柔比星处理前后的生物学行为,探讨表柔比星化疗对乳腺癌转移潜能的影响及机制。方法:人乳腺癌细胞MCF-7和MDA-MB-231分别给予正常培养和表柔比星6小时处理,通过划痕实验和transwell实验比较两组细胞迁移和侵袭能力的差别。MCF-7细胞经过表柔比星处理不同时间后,通过real-time PCR分析细胞中转移相关蛋白1(Metastasis Associated Protein 1,MTA1)表达水平的变化。建立小鼠4T1乳腺癌模型,观察表柔比星化疗对小鼠肺表面乳腺癌转移灶的数量的影响。结果:划痕实验中,处理组MCF-7和MDA-MB-231细胞24小时内平均划痕愈合距离均显著长于对照组细胞(P0.05);transwell实验中,处理组MDA-MB-231细胞24小时内穿膜细胞数显著多于对照组细胞(P0.01),MCF-7细胞本身侵袭性低难以穿膜;real-time PCR结果显示,表柔比星处理使MCF-7细胞中MTA1转录水平出现显著上调(P0.05);动物实验结果显示,处理组小鼠肺表面转移灶数量显著多于对照组(P0.01)。结论:表柔比星处理可以在体内和体外增强乳腺癌细胞的转移潜能,这一改变可能与其诱导MTA1的表达有关。     

Medroxyprogesterone and tamoxifen augment anti-proliferative efficacy and reduce mitochondria-toxicity of epirubicin in FM3A tumor cells in vitro

We have shown that low doses of medroxyprogesterone acetate (MPA- 2.6 microM) and tamoxifen (TAM- 270 nM) could augment the effectiveness of epirubicin in breast tumor cells. In this study, we monitored early cell kinetics (24-96 h plating and S-phase) and mitochondrial morphology during chemo-endocrine treatments to delineate the epirubicin sensitizing mechanism. S-phase fractions with radioactive thymidine uptake, plating efficacy, and transmission electron microscopic analysis were taken for 24-h periods until the 7th day after drug treatments. Despite strongly enhancing the clonogenic killing, both MPA and TAM did not affect epirubicin induced early cytotoxicity. Instead, they augmented the S-phase inhibition, which was even more pronounced for TAM. Epirubicin induced prominent swelling and crista damage of mitochondria and fragmentation of nuclei. Mitochondria were a normal size during a combination of epirubicin with either MPA- or tamoxifen treatment, despite the persistence of chromatin fragmentation and strong synergism on the clonogenic killing of breast tumor cells. Low dosage endocrine agent-induced anthracycline sensitization may be independent of mitochondrial toxicity. Further studies would be worthwhile, since the uncoupling of mitochondrial toxicity from the anti-neoplastic effect may also mean obviated cardiac toxicity in clinic.     

胃癌SGC7901 表柔比星耐药细胞亚系的建立与耐药机制研究

目的:建立人胃癌SGC7901表柔比星耐药细胞系,探讨其对表柔比星的耐药机制。方法:采用逐步增加表柔比星浓度,间歇作用体外诱导法,建立人胃癌SGC7901表柔比星耐药细胞亚系SGC7901/EPI。用MTT法测定药物敏感性;流式细胞仪检测其药物排除能力和凋亡抵抗能力等生物学指标的改变,western blot检测相关蛋白的表达。结果:经过12个月建成人胃癌SGC7901表柔比星耐药细胞系SGC7901/EPI,其对表柔比星明显耐药,且对其他多种抗癌药具有不同程度的交叉耐药性,阿霉素蓄积潴留实验显示SGC7901/EPI的阿霉素含量明显低于亲本细胞,Western blot显示MRP1的表达上调;SGC7901/EPI凋亡抵抗能力明显上升,Bcl-2表达比亲本细胞增高,而Bax的表达下调。结论:SGC7901/EPI细胞具有多药耐药表型,其可能通过MRP1的上调增加药物排出和上调Bcl-2/Bax的比值促进凋亡抵抗等机制产生耐药。该胃癌多药耐药细胞亚系为进一步研究胃癌耐药机制及逆转方法奠定基础。     

消癌平注射液联合表柔比星新辅助化疗对三阴性乳腺癌患者免疫功能、生活质量及血清肿瘤标志物的影响

摘要 目的：探讨消癌平注射液联合表柔比星新辅助化疗对三阴性乳腺癌（TNBC）患者免疫功能、生活质量及血清肿瘤标志物的影响。方法：选取TNBC患者89例,按照随机数字表法分为对照组和研究组,对照组（n=44）患者给予表柔比星新辅助化疗治疗,研究组（n=45）患者给予消癌平注射液联合表柔比星新辅助化疗。对比两组疗效、免疫功能、生活质量、血清肿瘤标志物及不良反应。结果：研究组治疗12周后的临床总有效率为91.11%（41/45）,高于对照组的63.64%（28/44）（P<0.05）。两组治疗12周后健康调查简表（SF-36）量表各维度评分升高,且研究组较对照组高（P<0.05）。两组治疗12周后CD4+CD25+Treg、Th17/ Treg均降低,且研究组较对照组低（P<0.05）,Th17升高,且研究组较对照组高（P<0.05）。两组治疗12周后癌胚抗原（CEA）、糖类抗原199（CA199）、糖类抗原125（CA125）均降低,且研究组较对照组低（P<0.05）。两组不良反应发生率对比未见差异（P>0.05）。结论：消癌平注射液联合表柔比星新辅助化疗治疗TNBC,具有确切的治疗效果,可降低血清肿瘤标志物水平,改善患者免疫功能和生活质量。     

Effect of phospholipid composition on pharmacokinetics and biodistribution of epirubicin liposomes

The effects of phospholipid composition on the pharmacokinetics (PK) and biodistribution of epirubicin (EPI) liposomes, as well as the in vitro macrophage uptake of various liposome formulations, were investigated. Three liposome formulations were investigated: HSPC:Chol (L-EPI; 5:4 molar ratio), HSPC:Chol:DSPG (D-EPI; 5:4:1 molar ratio), and HSPC:Chol:DSPG:DSPE-mPEG₂₀₀₀ (S-EPI; 5:4:1:0.3 molar ratio). Small unilamellar liposomes were prepared by the modified thin-film hydration method with extrusion through polycarbonate filters, and EPI was remote loaded into liposomes by the transmembrane ammonium sulfate gradient method. Macrophages were used to evaluate in vitro the cellular uptake of EPI-loaded liposomes. The following decreasing order of uptake amount was observed: L-EPI>D-EPI>S-EPI. D-EPI showed a relatively low level of uptake, probably because of the steric hindrance provided by the glycerol head group on DSPG, protecting it from the direct recognization by cell-membrane receptors. With the presence of serum, uptake values for all liposome formulations were increased for the activation of the complement system. In the PK study, S-EPI showed significantly prolonged circulating time and reduced clearance. The following increasing order of area under the concentration versus time curve was observed among the various liposome formulations: L-EPI<D-EPI<S-EPI. The biodistribution study indicated that S-EPI decreased drug disposition in the liver, spleen, lung, and heart and increased that in the kidney with respect to the other liposomes. The encouraging property of S-EPI, in terms of prolonging circulating time and reducing heart toxicity, might describe a promising perspective toward clinical application, and all the results would support further research into liposome-based drug carriers.     

提高表柔比星质量与生产水平的研究

柔红霉素产生菌S．Coeruleorubidus经N^ 、Co^60理化诱变剂选育后,获得的高产菌株经发酵罐应用后,其发酵产率分别提高25．8％、17．6％,累计净增利润超亿元,经分离收集的活性生物精品制成表柔比星,纯度提高4％,杂质比例下降2倍以上,收率提高50％,符合最新国际权威药典标准,产品畅销世界。     

不同手术方式联合新辅助化疗治疗乳腺癌患者的临床疗效对比

目的:探究不同手术方式联合新辅助化疗治疗乳腺癌患者的临床疗效。方法:选择2012年1月~2014年1月我院收治的80例乳腺癌患者为研究对象。综合考虑患者自主意愿、身体条件、经济状况,将80例乳腺癌患者分为A组(23例)和B组(57例)。两组患者均给予EC(表柔比星+环磷酰胺)方案新辅助化疗,在此基础上A组接受保乳术,B组接受改良根治术。比较两组患者临床疗效、乳房美容效果、生活质量、心理状态。结果:A组患者的住院时间、拔管时间均显著短于B组(P0.05),术中出血量、HAMA、HRSD评分、术后并发症的发生率明显低于B组(P0.05),乳房美容效果明显优于B组(P0.05),QLQ-BR23评分显著高于B组(P0.05)。两组患者随访期间的2年生存率、复发率比较差异均无统计学意义(P0.05)。结论:保乳术联合表柔比星新辅助化疗治疗乳腺癌的临床效果显著,可减少术后并发症,提高乳房美观度和患者的生活质量。