The therapeutic index of anti-
cancer drugs is increased when encapsulating them in
tumor-targeted
liposomes.
Liposome-entrapped
doxorubicin (DXR), targeting the
tumor vasculature marker,
aminopeptidase N (APN), displayed enhanced anti-
tumor effects and prolonged survival in human
neuroblastoma (NB)-bearing mice. Here we exploited a
peptide ligand of
aminopeptidase A (APA), discovered by phage display technology for delivery of liposomal DXR to perivascular
tumor cells. Immunohistochemistry, performed in NB-bearing mice, showed APA expression in the vascular wall of NB primary and metastatic lesions. APA-targeted
peptides displayed specific binding to APA-transfected cells in vitro, and also accumulation in the
tumor of NB-bearing mice. Consequently, novel, APA-targeted, DXR-
liposomes were developed and in vivo proof-of-principle was established, alone and in combination with APN-targeted DXR-loaded
liposomes, in NB-bearing mice. Mice receiving APA-targeted liposomal DXR exhibited an increased life span in comparison to control mice, but to a lesser extent relative to that in mice treated with APN-targeted formulation, moreover the greatest increase in TUNEL-positive
tumor cells was observed in animals treated with APN-targeted formulations. Mice treated with a combination of APA- and APN-targeted, liposomal DXR had a significant increase in life span compared to each treatment administered separately. There was a significant increase in the level of apoptosis in the
tumors of mice on the combination
therapy, and a pronounced destruction of the
tumor vasculature with nearly total ablation of endothelial cells and pericytes. The availability of novel
ligands binding to additional
tumor vasculature-associated
antigens will allow the design of sophisticated combinations of
ligand-targeted liposomal anti-
cancer drugs.