NON-IODINATED RADIOLABELED RADIOPAQUE MICROBEADS WITH MRI CONTRAST FOR RADIOEMBOLIZATION
20190167822 ยท 2019-06-06
Inventors
- Manzoor Koyakutty (Kochi, IN)
- Vijay Harish Somasundaram (Kochi, IN)
- Anusha Ashokan (Kochi, IN)
- Shantikumar Nair (Kochi, IN)
Cpc classification
A61K49/0002
HUMAN NECESSITIES
A61K45/06
HUMAN NECESSITIES
A61K51/0474
HUMAN NECESSITIES
A61K49/0419
HUMAN NECESSITIES
A61K51/1251
HUMAN NECESSITIES
A61K49/1821
HUMAN NECESSITIES
International classification
A61K51/12
HUMAN NECESSITIES
A61P35/00
HUMAN NECESSITIES
Abstract
The invention discloses non-iodinated radiopaque microbeads that may be used in image guided embolization in a subject ailing with tumor. The non-iodinated radiopaque microbeads include a ceramic material doped with a CT contrast agent or a MRI contrast agent or both. The doped ceramic is blended with a polymer and the blend is electrosprayed to form the radiopaque microbeads. Further the radiopaque microbeads are radiolabeled with a radioactive isotope. Methods of synthesis of the radiopaque microspheres are also disclosed. The non-iodinated radiopaque microbeads with radiolabeling are capable of rendering an imageable computed tomography (CT) contrast or magnetic resonance imaging (MRI) contrast when administered in a subject. Also the microspheres are biodegradable and hence the treatment could be repeated in case of recurrence of the tumor in the subject.
Claims
1. A non-iodinated, radiopaque microbead or microsphere composition for use in image-guided embolization or radioembolization in a subject, comprising: a ceramic material (C), comprising an impurity dopant (X), wherein the impurity dopant X is present at a concentration of 0-30% (w/w) and is selected from molybdenum, tungsten, zirconium or gold or a combination thereof; a polymer binder blended to the ceramic material; and a radioisotope conjugated to the ceramic material or the microbeads, wherein the composition renders imageable computed tomography (CT) contrast or magnetic resonance imaging (MRI) contrast, or both, when administered to the subject.
2. The composition of claim 1, wherein the image-guided embolization is selected from transarterial embolization (TE), transarterial radioembolization (TARE) or Selective Internal Radiation Therapy (SIRT) of tumors.
3. The composition of claim 1, wherein the size of the microsphere is 1-1500 m.
4. The composition of claim 1, further comprising a magnetic resonance imaging (MRI) contrast agent or dopant, doped or loaded in the ceramic material.
5. The composition of claim 4, wherein the MRI contrast agent is selected from iron, manganese, terbium, erbium, dysprosium, holmium, thulium, bismuth, barium, strontium, iodine, zirconium, lanthanides, hafnium or aluminium.
6. The composition of claim 1, wherein the ceramic is selected from the group consisting of alumina, zirconia, silica, hydroxyapatite, calcium aluminate, bioactive glass, cerium oxide, calcium sulphate, calcium molybdate, calcium silicates, calcium carbonate, -tricalcium phosphate, -tricalcium phosphate, octocalcium phosphate, dicalcium phosphates, tetracalcium phosphate monoxide, ferric-calcium-phosphorus oxides, biocorals or any combination thereof.
7. The composition of claim 1, wherein the polymer is selected from the group comprising of polyvinyl alcohols, polyacrylic acids, polymethacrylic acids, polyethylenimines, poly vinyl sulphonates, carboxymethyl celluloses, hydroxymethyl celluloses, oxidized cellulose, gellan, gum arabic, substituted celluloses, polyanhydrides, poly (ortho)esters, polyacrylamides, polyethylene glycols, polyamides, polyvinylpyrrolidones, polyureas, polyurethanes, polyesters, polyethers, polystyrenes, polysaccharides, polylactic acids, polyethylenes, polymethyl methacrylates, polycaprolactones, polyvinyl acetate, polyglycolic acids, poly(lactic-co-glycolic) acids, albumin, transferrin, caseins, gelatin, mannose, sucrose, starch, galactose, galactomannans, or a combination thereof.
8. The composition of claim 1, wherein the polymer is a biopolymer selected from alginate, gelatin, collagen, chitosan, carboxymethyl chitosan, chitin, cellulose, carboxymethyl cellulose, dextran, fibrin, hyaluronic acid, chondroitin sulphate, agarose, starch, poly[lactic-co-glycolic] acid, poly-L-lactic acid, polylactic acid, polycaprolactone, polyvinyl alcohol, polyhydroxy butyrate, polyhydroxy butyrate co hydroxyvalerate, polyphosphazenes, polyurethane, or polyanhydrides.
9. The composition of claim 1, wherein the polymer is present at a concentration of 0-30% (w/w) of the ceramic.
10. The composition of claim 1, wherein the microspheres are biodegradable and undergo degradation in at least two months.
11. The composition of claim 1, wherein the composition is administered by intra-arterial, transarterial, intra-articular or local route.
12. The composition of claim 1, wherein the microspheres are non-iodinated and show combinatorial CT and MRI contrast in T2 mode with relaxivity of at least R.sub.2=17 mM.sup.1s.sup.1.
13. The composition of claim 1, the radioisotope is selected from .sup.99mTc, .sup.111In, .sup.123I, .sup.131I, .sup.188Re, .sup.186Re, .sup.166Ho, .sup.32P, .sup.18F, .sup.68Ga, .sup.177Lu, .sup.90Y, .sup.166Dy, .sup.103Pd, .sup.169Yb, .sup.212Bi, .sup.213Bi, .sup.212Po, .sup.225Ac, .sup.211At, .sup.89Sr, .sup.192Ir, .sup.194Ir or .sup.223Ra conjugated to the microspheres.
14. A method of synthesis of radiopaque microsphere or microbeads capable of rendering an imageable computed tomography (CT) contrast when administered in a subject comprising: doping or co-loading an impurity dopant in a ceramic to obtain a ceramic material, wherein the impurity dopant is present at a concentration of 0-30% (w/w) and is selected from molybdenum, tungsten or zirconium or a combination thereof, for X ray contrast and from iron, manganese, terbium, erbium, dysprosium, holmium, thulium, bismuth, barium, strontium, iodine, zirconium, lanthanides, hafnium or aluminium or thereof, for MRI contrast; blending the ceramic material with a polymer solution; electrospraying the blend with or without a crosslinker to form microbeads; incubating the formed microbeads at an optimum temperature for 48 hours and radiolabeling the microbeads with a radioisotope to produce the radiolabeled radiopaque microbeads.
15. The method of claim 14 wherein the crosslinker is selected from one of bivalent cationic solutions comprising calcium chloride, stannous chloride, barium chloride or ferric chloride, carbodiamides, EDC, trivinyl sulphones, acrylamides, epoxides, polyamides, maleimide, iminoesters, or combinations thereof.
16. The method of claim 14 further comprising the step of calcining the beads in the temperature range 100-1000 C. to produce the radiopaque beads.
17. The method of claim 14 wherein the beads are further subjected to lyophilization to produce the radiopaque beads.
18. The method of claim 14, wherein the synthesized microbeads are non-iodinated
19. The method of claim 14, wherein the radiolabeling of microbeads is done either by direct interaction or by using an appropriate ligand or chelating agent.
20. The method of claim 19 wherein, the ligand or chelating agent is selected from bisphosphonates, DMSA, DMDTPA, ethylene dicysteine, mercaptoacetyltriglycine, hydrazinonicotinamide, iminodiacetic acid, a crown ether, DTPA monoamide, EDTA, DOTA, EGTA, BAPTA, DO3A, NOTA-Bn, styrene, butyl acrylate, glycidil methacrylate, aminocarboxylic acids, NODASA, NODAGA, peptides, oligomers, amino acids, 10-decanedithiol (HDD), ethyl cysteinate dimer complexes, DEDC, methoxyisobutylisonitrile, or derivatives or combinations thereof.
21. The method of claim 19, wherein the ligand or chelating agent, with or without radiolabeling, is either covalently or electrostatically bound to the microbeads.
22. The method of claim 14, further comprising conjugating the microsphere with a chemotherapeutic agent.
23. A method of medical treatment of a tumor in a mammal comprising: administering a therapeutically effective amount of a non-iodinated, radiopaque microbead or microsphere composition for use in image-guided embolization or radioembolization of the tumor, comprising: a ceramic material (C), comprising an impurity dopant (X), wherein the impurity dopant is present at a concentration of 0-30% (w/w) and is selected from molybdenum, tungsten, zirconium or gold or a combination thereof; a polymer binder blended to the ceramic material, and a radioisotope conjugated to the ceramic material or the prepared microbeads, wherein the composition renders imageable computed tomography (CT) contrast or magnetic resonance imaging (MRI) contrast, or both, when administered to the subject.
24. The method of claim 23 wherein the non-iodinated radiopaque microbeads are used in combination with radiofrequency ablation, chemotherapy or immunotherapy.
25. The method of claim 23 wherein the non-iodinated radiopaque microbeads are biodegradable.
26. The method of claim 23 wherein the method is repeated on re-occurrence of the tumor.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] The invention has other advantages and features which will be more readily apparent from the following detailed description of the invention and the appended claims, when taken in conjunction with the accompanying drawings, in which:
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DETAILED DESCRIPTION
[0047] While the invention has been disclosed with reference to certain embodiments, it will be understood by those skilled in the art that various changes may be made and equivalents may be substituted without departing from the scope of the invention. In addition, many modifications may be made to adapt to a particular situation or material to the teachings of the invention without departing from its scope.
[0048] Throughout the specification and claims, the following terms take the meanings explicitly associated herein unless the context clearly dictates otherwise. The meaning of a, an, and the include plural references. The meaning of in includes in and on. Referring to the drawings, like numbers indicate like parts throughout the views. Additionally, a reference to the singular includes a reference to the plural unless otherwise stated or inconsistent with the disclosure herein.
[0049] The present invention in various embodiments relates to microbead composition and in particular to radiopaque microspheres that may be used in image guided embolization in a subject. Further, a method of synthesis of the radiopaque microspheres, that are capable of rendering an imageable computed tomography (CT) contrast along with radiolabeled contrast when administered in a subject is disclosed.
[0050] In various embodiments the non-iodinated radiopaque microsphere composition with radiolabeling 100 as shown in
[0051] In various embodiments the ceramic material 111 may include one or more elements as shown in
[0052] In various embodiments the ceramic material 111 may include one or more of alumina, zirconia, silica, hydroxyapatite, calcium aluminate, bioactive glass, cerium oxide, calcium sulphate, calcium molybdate, calcium silicates, calcium carbonate, calcium phosphates, -tricalcium phosphate, -tricalcium phosphate, octocalcium phosphate, dicalcium phosphates, tetracalcium phosphate monoxide, ferric-calcium-phosphorus oxides or Bio-corals.
[0053] In various embodiments the impurity dopant 112 that is doped with the ceramic material 111 to form the radiopaque ceramic material 116 as shown in
[0054] In some embodiments the radiopaque microsphere composition 110 is either doped or loaded with an MRI contrast agent 113 to enable temporary visualization of the site of delivery of the microsphere. In various embodiments the MRI contrast agent 113 that is doped with the microsphere composition is selected from one or more of iron, manganese, terbium, erbium, dysprosium, holmium, thulium, bismuth, barium, strontium, iodine, zirconium, lanthanides, hafnium or aluminium.
[0055] In some embodiments a polymer 115 as shown in
[0056] In some embodiments the polymer 115 that is blended to the ceramic material may include one or more biopolymers including alginate, gelatin, collagen, chitosan, carboxymethyl chitosan, chitin, cellulose, carboxymethyl cellulose, dextran, fibrin, hyaluronic acid, chondroitin sulphate, agarose, starch, poly[lactic-co-glycolic] acid, poly-L-lactic acid, polylactic acid, polycaprolactone, polyvinyl alcohol, polyhydroxy butyrate, polyhydroxy butyrate co hydroxyvalerate, polyphosphazenes, polyurethane, or polyanhydrides.
[0057] In some embodiments the radioisotope 150 as shown in
[0058] The radiolabeled radiopaque microsphere composition 110 in some embodiments may be used in imaged-guided embolization that may include transarterial embolization (TE), transarterial radioembolization (TARE) or Selective Internal Radiation Therapy (SIRT) of tumors.
[0059] In various embodiments the size of the radiopaque microspheres ranges from 1-1500 m. In various embodiments the radiopaque microspheres are biodegradable and may degrade within 2 months of their administration in the subject. Biodegradability of the microspheres may allow clearance of the blocked blood vessel that leads to the tumor. This may allow re-treatment of residual or recurrent tumors with another sitting of TARE.
[0060] In some embodiments the radiopaque microsphere composition is administered in the subject is done under image guidance through any of intra-arterial, transarterial, intra-articular or local routes.
[0061] In some other embodiments the radiolabeled radiopaque microsphere composition are non-iodinated and show combinatorial CT and MRI contrast. Hence these non-iodinated radiopaque microsphere embolizing agents may allow direct assess of the target tissue embolization by image guidance and may also help identify non-target sites that may have been accidentally embolized during the procedure. Further, the radiolabeled radiopaque microbeads will also allow follow up assessment of the patients without need of additional iodinated soluble contrast administration.
[0062] In some embodiments a chemotherapeutic agent or an immunotherapy agent may be conjugated with the radiopaque microsphere composition and could be used in TA and TARE procedures. In some embodiments the chemotherapeutic agent is selected from one or more of doxorubicin, daunorubicin, temozolomide, carmustine, cisplatin, paclitaxel, curcumin or small molecule tyrosine kinase inhibitors.
[0063] In some other embodiments the radiopaque microspheres are pliable when moist and may be compressed to at least to 70% of the initial diameter. This property ensures that the microspheres can easily pass through small-bore catheters without breakage. In various embodiments the radiopaque microspheres may attenuate X-ray in the range 30-3000HU and in various embodiments may emit one or more of , , or radiation.
[0064] In various embodiments the invention includes a method of synthesis 200 of radiopaque microsphere or microbeads. The radiopaque microsphere or microbead is capable of rendering an imageable computed tomography (CT) contrast when administered in a subject. In various embodiments the method includes the following steps. In step 201 an impurity dopant (X) is either doped or co-loaded in a ceramic (C) to obtain a ceramic material (C-X). The impurity dopant (X) is present at a concentration of 0-30% (w/w) and may include one or more of molybdenum, tungsten, or zirconium. In step 202 the ceramic material is blended with a binder solution to form a blended binder solution. The binder solution may include a polymer solution. The blended binder solution is electrosprayed into a crosslinker in step 203 to form microspheres or microbeads. Further the formed microbeads in step 203 are incubating in step 204 at a temperature range of 35 C.-95 C. for 48 hours. In step 205 the incubated microbeads are radiolabeled with a radioisotope to produce the radiopaque microbeads.
[0065] In various embodiments the binder solution that forms a blend of the ceramic material may include one or more of polyvinyl alcohols, polyacrylic acids, polymethacrylic acids, polyethylenimines, poly vinyl sulphonates, carboxymethyl celluloses, hydroxymethyl celluloses, substituted celluloses, polyanhydrides, poly (ortho)esters, polyacrylamides, polyethylene glycols, polyamides, polyvinylpyrrolidones, polyureas, polyurethanes, polyesters, polyethers, polystyrenes, polysaccharides, polylactic acids, polyethylenes, polymethyl methacrylates, polycaprolactones, polyvinyl acetate, polyglycolic acids, poly(lactic-co-glycolic) acids, albumin, transferrin, caseins, gelatin, mannose, sucrose, starch, galactose, galactomannans, or a combination thereof.
[0066] In some embodiment the crosslinker may include one or more of bivalent cationic solutions comprising calcium chloride, stannous chloride, barium chloride or ferric chloride, carbodiamides, EDC, trivinyl sulphones, acrlyamides, epoxides, polyamides, maleimide, or iminoesters.
[0067] In some embodiments the method may include the step of annealing or calcining the microspheres in the temperature range 100-1000 C. to produce the radiopaque beads. In some embodiments the microspheres could be lyophilized.
[0068] In various embodiments the radiolabeling of microbeads are done with appropriate clinically approved radioisotopes that have a radiolabeling efficiency of 85%. In some embodiments the clinically approved radioisotopes may include one or more of .sup.188Rhenium, .sup.99mTc, .sup.111In, .sup.123I, .sup.131I, .sup.188Re, .sup.186Re, .sup.166Ho, .sup.32P, .sup.18F, .sup.68Ga, .sup.177Lu, .sup.90Y, .sup.166Dy, .sup.103Pd, .sup.169Yb, .sup.212Bi, .sup.213Bi, .sup.212Po, .sup.225Ac, .sup.211At, .sup.89Sr, .sup.192Ir, .sup.194Ir or .sup.223Ra. In some embodiments the radiolabeling may be performed either by direct interaction or by using an appropriate ligand or chelating agent. In some embodiments the chelating agent are either covalently or electrostatically bound to the microsphere during their preparation. A major advantage of the disclosed embodiments is that the radiopaque, biodegradable microbeads, can efficiently be radiolabeled in-house within the hot-lab at any nuclear medicine department. This will allow readily available radioactive microbeads of any desired dosage, which can be specifically tailored by the clinicians by a patient.
[0069] In some embodiments the ligand or chelating agent that is either covalently or electrostatically bound to the microsphere may include one or more of bisphosphonates, DMSA, DMDTPA, ethylene dicysteine, mercaptoacetyltriglycine, hydrazinonicotinamide, iminodiacetic acid, a crown ether, DTPA monoamide, EDTA, DOTA, EGTA, BAPTA, DO3A, NOTA-Bn, styrene, butyl acrylate, glycidil methacrylate, aminocarboxylic acids, NODASA, NODAGA, peptides, oligomers, amino acids, 10-decanedithiol (HDD), ethyl cysteinate dimer complexes, DEDC, methoxyisobutylisonitrile, or derivatives.
[0070] In various embodiments a method of medical treatment of a tumor in a mammal is disclosed. The method includes administering a therapeutically effective amount of the non-iodinated, radiopaque microbead or microsphere composition into the subject. In various embodiments the method is used in image-guided embolization or radioembolization of the tumor. A radioisotope may conjugated to the ceramic material or the prepared microbeads that may render imageable computed tomography (CT) contrast or magnetic resonance imaging (MRI) contrast, or both, when administered to the subject.
[0071] In various embodiments the non-iodinated radiopaque microbeads with MRI imageability for transarterial radioembolization can be used in patients with specific allergies toward iodinated contrast agents. Also these microbeads may be used in patients with deranged renal function in whom iodinated contrast cannot be used. Also, CT and MRI imageability allows imaging guided administration of the microbeads that may identify the actual location of the microbeads in the embolized tumor vessel. The CT and MRI imageability may also identify if the microbeads block the tumor vessels or if the microbeads have moved into other adjacent vessels which supply blood to normal structures. Also CT and MRI imageability of the microbeads allow follow up of patients without need for additional use of contrast for imaging guided procedures like radiofrequency ablation, microwave/alcohol ablation.
[0072] Further the biodegradability of the microbeads allows retreatment by TARE, using the radiolabelled microbeads in case of recurrent/residual tumors at the initial site. This is possible because the blood vessels are not permanently blocked. Also the damage to normal tissue around the tumor are reduced as branches supplying normal tissue, if accidently blocked will reopen after the beads degrade. The microbeads may be indigenously produced using more affordable materials that makes it more affordable to patients especially in developing countries. Further the microbeads may be radiolabelled in any standard nuclear medicine department hot-lab. This reduces the shipment cost because the unlabelled microbeads do not require any radiation protection measures during shipment. Dosage of radioisotope for radiolabelling can be decided by the doctor on a patient specific basis. Radiopaque microbeads without radiolabeling may also be used for embolization of benign conditions like arteriovenous malformations.
[0073] While the invention has been disclosed with reference to certain embodiments, it will be understood by those skilled in the art that various changes may be made and equivalents may be substituted without departing from the scope of the invention. In addition, many modifications may be made to adapt to a particular situation or material the teachings of the invention without departing from its scope. Further, the examples to follow are not to be construed as limiting the scope of the invention which will be as delineated in the claims appended hereto.
EXAMPLES
Example 1: Preparation of Molybdenum Doped Calcium Phosphate and Calcium Molybdate
[0074] 20 ml of 0.5M calcium chloride (Sigma, USA) was mixed with 0.1M ammonium molybdate (Nice Chemicals, India). Volume of ammonium molybdate varied as per required doping percentage (degree of radiopacity). 10 ml of 0.3M diammonium hydrogen phosphate (Fisher Scientific, India) mixed with 10 ml of 3N ammonium hydroxide (Fisher Scientific, India) was added drop-wise to the above mixture shown in
Example 2: Preparation of Calibrated Radiopaque Microbeads
[0075] Molybdenum doped (in optimized concentration) calcium phosphate (prepared as described above) was blended with 2% (w/v) sodium alginate solution (in distilled water) in a 4:1 (w/w) concentration. This blend was electrosprayed as illustrated in
Example 3: Demonstrating Characteristics of the Radiopaque Microbeads
[0076] Optical and SEM imaging (
Example 4: Demonstration of Degradation of the Radiopaque Microbeads
[0077] In vitro degradation of the radiopaque microbeads was tested by incubating them in phosphate buffered saline at 37 C. in a shaking incubator. The microbeads showed early signs of degradation after a period of 2 months. In vivo degradation of the microbeads was demonstrated by implanting them subcutaneously in NZW rabbit models and then perform serial imaging (X-ray) at regular intervals to look for reduction in the x-ray attenuation of the microbeads.
Example 5: In Vivo Demonstration of the Embolizing Potential of the Radiopaque Microbeads
[0078] The NZW rabbit renal (kidney) artery embolization model was selected for demonstration of the image guided embolization potential of the radiopaque microbeads. Under image guidance (x-ray C-arm from GE Healthcare) a (clinically used) 4-French arterial catheter was passed in the descending abdominal aorta of the animal via its right carotid artery. The right renal artery was preferentially catheterized and its patency demonstrated by x-ray contrast angiography as shown in