Treatment of patients with aortic atherosclerotic disease with paclitaxel-associated lipid nanoparticles.

Abstract

OBJECTIVE:

The toxicity of anti-cancer chemotherapeutic agents can be reduced by associating these compounds, such as the anti-proliferative agent paclitaxel, with a cholesterol-rich nanoemulsion (LDE) that mimics the lipid composition of low-density lipoprotein (LDL). When injected into circulation, the LDE concentrates the carried drugs in neoplastic tissues and atherosclerotic lesions. In rabbits, atherosclerotic lesion size was reduced by 65% following LDE-paclitaxel treatment. The current study aimed to test the effectiveness of LDE-paclitaxel on inpatients with aortic atherosclerosis.

METHODS:

This study tested a 175 mg/m2 body surface area dose of LDE-paclitaxel (intravenous administration, 3/3 weeks for 6 cycles) in patients with aortic atherosclerosis who were aged between 69 and 86 yrs. A control group of 9 untreated patients with aortic atherosclerosis (72-83 yrs) was also observed.

RESULTS:

The LDE-paclitaxel treatment elicited no important clinical or laboratory toxicities. Images were acquired via multiple detector computer tomography angiography (64-slice scanner) before treatment and at 1-2 months after treatment. The images showed that the mean plaque volume in the aortic artery wall was reduced in 4 of the 8 patients, while in 3 patients it remained unchanged and in one patient it increased. In the control group, images were acquired twice with an interval of 6-8 months. None of the patients in this group exhibited a reduction in plaque volume; in contrast, the plaque volume increased in three patients and remained stable in four patients. During the study period, one death unrelated to the treatment occurred in the LDE-paclitaxel group and one death occurred in the control group.

CONCLUSION:

Treatment with LDE-paclitaxel was tolerated by patients with cardiovascular disease and showed the potential to reduce atherosclerotic lesion size.

• Authors: Afonso A Shiozaki, Tiago Senra, Aleksandra T Morikawa, Débora F Deus, Antonio T Paladino-Filho, Ibraim M F Pinto, Raul C Maranhão
• Journal: Clinics (Sao Paulo, Brazil) (Clinics (Sao Paulo)) Vol. 71 Issue 8 Pg. 435-9 (Aug 2016) ISSN: 1980-5322 [Electronic] United States
• PMID: 27626473 (Publication Type: Controlled Clinical Trial, Journal Article)

Chemical References

• Fat Emulsions, Intravenous
• Triglycerides
• Tubulin Modulators
• Cholesterol
• Paclitaxel

Topics

• Aged
• Aged, 80 and over
• Angiography
• Aorta, Thoracic (drug effects)
• Aortic Diseases (diagnostic imaging, drug therapy)
• Atherosclerosis (diagnostic imaging, drug therapy)
• Cholesterol (blood, therapeutic use)
• Drug Delivery Systems
• Fat Emulsions, Intravenous (therapeutic use)
• Female
• Humans
• Male
• Multidetector Computed Tomography
• Nanoparticles (therapeutic use)
• Paclitaxel (therapeutic use)
• Reproducibility of Results
• Time Factors
• Treatment Outcome
• Triglycerides (blood)
• Tubulin Modulators (therapeutic use)