relapsed ovarian cancer in lymphnodes

[amritaanp]

hi
my mom has been diagnosed to ovarian cancer during 2006. We gave her first line chemo(carboplatin+taxol). After one year the cancer has relapsed. We gave her the second line(doxorubicin) chemo. For the past one year she was fine. Now she have got cancer cells spread in the lymph nodes ie two nodes in external illiac measuring 2 cm, two paraaortic nodes in the infrarenal measuring the same, nodes on both lopes of liver, nodes near kidney,and t2 hyperintense lessions near D12 and L1 vertebrae.Our doctor prescribes carboplatin+nano paclitaxel for this chemo. We have never heard of this drug and have no info about this drug.Is this safe or we can go on with our old one(carboplatin+paclitaxel). What is the better one and why? Pl reply

[Annekathryn Goodman, M.D.]

Hi There
that is a perfectly good combination
there may be more nausea but less bone marrow suppression with cisplatin compared to carboplatin
please keep in touch
best wishes

[amritaanp]

thanks dr,
we have given abraxane with cisplatin... I need to know whether this combination will be more effective than abraxane with carboplatin.. so that we can switch the drug by the next cycle..

[Annekathryn Goodman, M.D.]

Hi There
I am unfamiliar with this
I have pasted examples of what a I found from searching Google and also pub med

it seems that this technology wraps taxol in a sphere in a manner similar to doxil which is adriamycin wrapped in a liposome. There do not appear to be publications of clinical trials in humans for nano taxol. You should ask your doctor for papers showing results in humans. If there are none - don't use it. That would be very unsafe. I did have a patient on a clinical trial phase I trial last year of an agent that sounded similar.She sloughed her intestine and almost died

2008 a prepublication announcement:
A novel formulation of paclitaxel (PTX) has been developed by providing multilayer assembly over drug loaded porous CaCO3 microparticles (CaCO3 MP) using combination of biocompatible and biodegradable polyelectrolytes (PE’s). PTX was encapsulated into the nanopores of preformed CaCO3 MP prepared by the co-precipitation method. Infrared (IR) and X-ray diffraction (XRD) provides evidences that PTX has been encapsulated into nanopores of CaCO3 MP and not crystallized on the surface. PTX loaded CaCO3 MP (CaCO3-PTX) was found to be highly stabilized against thermal decomposition as evinced by thermo gravimetric analysis (TGA) indicating decomposition at 600°C and 250°C for CaCO3-PTX and PTX respectively. The multilayer assembly over CaCO3-PTX was effectuated by alternate deposition of protamine sulfate (PRM) and sodium alginate (SA) using LBL technique followed by subsequent core removal [PTX- (PRM/SA)5]. The pay load efficiency of PTX in this system was found to be 78.98±2.14%. The developed system was further evaluated for surface morphology, size and size distribution, surface charge, core removal and layer-by-layer growth due to sequential adsorption of PE’s. The release data of PTX-(PRM/SA)5 was comparable with marketed formulation of PTX (PTX-M) and CaCO3-PTX when performed in simulated intestinal fluid (SIF pH=7.4). The release profile of PTX-(PRM/SA)5 indicates that PEs based multilayer matrix is capable to provide barrier to PTX release as it has been found to follow first order matrix diffusion kinetics with 64±4.8% release within 24 hrs. The t50% of PTX-M, CaCO3-PTX and PTX-(PRM/SA)5 was found to be 70, 90 and 480 minutes respectively. This alternative delivery system of PTX disguised in the form of LBL assembly could have immense application for the treatment of metastasized mammary glands vis-à-vis existing formulation of PTX which is by and large criticized for having certain toxic excipients to be given parentrally. Moreover, the proposed system provides ample of opportunity to modify the surface for targeted application of PTX.



Int J Pharm. 2010 Jun 15;392(1-2):51-6. Epub 2010 Mar 16.

In vivo efficacy of paclitaxel-loaded injectable in situ-forming gel against subcutaneous tumor growth.
Lee JY, Kim KS, Kang YM, Kim ES, Hwang SJ, Lee HB, Min BH, Kim JH, Kim MS.

Nano Bio Fusion Research Center, Korea Research Institute of Chemical Technology, Daejeon, Republic of Korea.

Abstract
Injectable in situ-forming gels have received considerable attention as localized drug delivery systems. Here, we examined a poly(ethylene glycol)-b-polycaprolactone (MPEG-PCL) diblock copolymer gel as an injectable drug depot for paclitaxel (Ptx). The copolymer solution remained liquid at room temperature and rapidly gelled in vivo at body temperature. In vitro experiments showed that Ptx was released from MPEG-PCL copolymer gels over the course of more than 14 days. Experiments employing intratumoral injection of saline (control), gel-only, Taxol, or Ptx-loaded gel into mice bearing B16F10 tumor xenografts showed that Ptx-loaded gel inhibited the growth of B16F10 tumors more effectively than did saline or gel alone. Further, intratumoral injection of Ptx-loaded gel was more efficacious in inhibiting the growth of B16F10 tumor over 10 days than was injection of Taxol. A histological analysis demonstrated an increase in necrotic tissue in tumors treated with Ptx-loaded gel. In conclusion, our data show that intratumoral injection of Ptx-loaded MPEG-PCL diblock copolymer yielded an in situ-forming gel that exhibited controlled Ptx release profile, and that was effective in treating localized solid tumors.