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Comparison of drug release and pharmacokinetics after transarterial chemoembolization using diverse lipiodol emulsions and drug-eluting beads.

Abstract
In many studies for chemoembolization of hepatocellular carcinoma, the Lipiodol emulsion preparation protocols, especially the mixing steps, were unclear or even unrevealed at all. However, doxorubicin (DOX) release may depend on the composition and volume ratio (Lipiodol to DOX solution) of a Lipiodol emulsion. Therefore, we conducted a preclinical study to compare in-vitro drug release and in-vivo pharmacokinetics of DOX from diverse Lipiodol emulsions and drug-eluting beads (DEBs) and to compare the tumor response in a rabbit VX2 carcinoma model. DOX release profiles of four types of Lipiodol emulsions with different media (normal saline or Pamiray as an iodinated contrast medium), volume ratio (Lipiodol to DOX solution), and DEBs were investigated in-vitro. For the in-vivo study, 15 rabbits bearing VX2 carcinoma in the liver were treated with 4∶1 volume ratio Lipiodol emulsion (group A), 1∶1 volume ratio Lipiodol emulsion (group B), and DEBs (group C) chemoembolization. Blood and tissue sampling was conducted to evaluate DOX concentration in plasma and tissues, histological changes, and liver toxicity. The most stable emulsion was formed with Pamiray (including DOX) at a 4∶1 volume ratio. The AUC value of group A was significantly lower than that of group B (p = 0.003) but comparable to that of group C (p = 0.071). The Cmax value of group A was significantly different compared with those of group B (p = 0.004) and C (p = 0.015). The tissue drug concentration in group A was comparable to that in group C (p = 0.251). No viable tumor was detected in rabbits of group A and B. In group C, viable tumor less than 10% was seen in two of the five rabbits. There were no significant differences in liver enzyme levels after the procedure. In conclusion, DOX release and pharmacokinetics of presented emulsion systems depend substantially on their composition. Therefore, Lipiodol emulsion type should be considered when interpreting data and designing new studies dealing with chemoembolization.
AuthorsJin Woo Choi, Hyun-Jong Cho, Ju-Hwan Park, Song Yi Baek, Jin Wook Chung, Dae-Duk Kim, Hyo-Cheol Kim
JournalPloS one (PLoS One) Vol. 9 Issue 12 Pg. e115898 ( 2014) ISSN: 1932-6203 [Electronic] United States
PMID25551760 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibiotics, Antineoplastic
  • Drug Carriers
  • Emulsions
  • Ethiodized Oil
  • Doxorubicin
Topics
  • Animals
  • Antibiotics, Antineoplastic (blood, pharmacokinetics, therapeutic use)
  • Carcinoma, Hepatocellular (drug therapy)
  • Chemoembolization, Therapeutic (methods)
  • Doxorubicin (blood, pharmacokinetics, therapeutic use)
  • Drug Carriers (pharmacokinetics, therapeutic use)
  • Drug Liberation
  • Emulsions (therapeutic use)
  • Ethiodized Oil (pharmacokinetics, therapeutic use)
  • Liver Neoplasms (drug therapy)
  • Microspheres
  • Rabbits

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