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Nano-Vehicular Targeted Drug Delivery Gabriel Lavella, Jaehyun Park, Jaeseok Jeon EE235 Final Project May 11, 2009 Electrical Engineering and Computer Sciences University of California, Berkeley • Overview of Drug Delivery • Targeted Drug Delivery • Current Anti-Cancer Strategies • U.S. Cancer Statistics • Nano-Engineered Cancer Treatment Solution Drug Delivery • In vast majority cases, drugs are delivered throughout the body via circulatory system • Example : Intravascular injection or oral ingestion Tablet of Chitosan and Enteric-coated layers Stomach : where coated tablet remain intact Small intestine : where enteric-coated layer dissolves Large intestine : where Chitosan-coated layer disintegrates Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 3 Targeted Drug Delivery • Method of delivering medication preferentially – To the right place in a body – At the right time, the right dose – For the right time period – NOT to the other places where drug side-effects may arise Active Receptor Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 4 Surgery • Surgical excision of cancer tissues • Accompany pain, risk of infection, poor wound healing Radiation • Method of completely killing cancer cells or shrinking tumors or relieving symptoms using high-energy radiation • Harm health tissues and damage nearby normal cells • Accompany pain, nausea, hair loss, damage to normal cells Chemotherapy • Chemical method of killing cells that divide rapidly (cancer cells) • Kills normal cells that divide rapidly under normal conditions • Accompany pain, nausea, memory loss, malnutrition Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 5 About 0.5 Million Expected to Die of Cancer in 2008 Overall Costs of Cancer in 2007 = $219.2 Billion • $89 billion for health expenditures • $18.2 billion for productivity loss due to illness • $112 billion for productivity loss due to premature death Lack of Health Care and Other Barriers 34% Leading causes of death in 1999, adults ages > 25 Cancer : 1 of every 4 deaths! 42% Cardiovascular Disease 24% Other Causes Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 6 Estimated Number of NEW Cancer Cases for 2008 Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 7 Blood stream Targeted Drug Delivery Systems • Nano-particle that carries attached drug to the site of action, with its path monitored by attached fluorescent detecting agent Tumor Cell Target to tumor cell Technical Advantages • Higher efficacy resulting from selectively targeting and killing cancer cells • Reduced toxicity and lower side-effects Monitor targeting • Potentially more cost-effective • Prospect for shorter treatments times Signaling Agent Targeting Agent Drug Released inside tumor cell Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project Smuggle attached drug into tumor cell 8 • Dendrimers : Introduction / Characteristics • Multifunctional Dendrimers as Drug Delivery • Targeting to Cancer Cells • DNA-Linked Dendrimers • Fabrication Process • Experiments Dendrimers : Repeatedly Branched Molecules • Consist of a series of chemical shells built on a small core molecule • Each shell (generation) consists of monomer layers, made by repeating chemical-linking • Beyond G5 : Begin to become spherical and 3-D structure Surface Groups • Can be variously functionalized • Cationic / Anionic / Neutral • Targeting groups • Dyes & Biomarkers Similarity to Protein • Size / Weight • Very well-defined chemical structure • Ease of cellular uptake Dendrimers : Ideal Building Block for Creating a Biologically Active Nano-material Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 10 Possible Tasks Can Be Performed • Diseased cell recognition • Reporting detection • Diagnosis of disease state • Reporting outcome of therapy • Drug delivery Multifunctional Dendrimers • Multiple functions can be bound onto dendrimers Targeting Agent Detecting Agent Therapeutic Agent Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 11 To Target Specifically to Cancer Cells • Cells have on their surfaces receptors for specific molecules • Specific receptors for specific molecules are targeted • Specificity can be precisely controlled by targeting active receptor • Taken up into the cell through specific receptor on cancer cell Fluorescent tagged nanodevice are taken up through the receptors then spread into cytosolic area Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 12 Targets : Folic Acid (FA) • FAR (high affinity receptor for FA) : overexpressed in several human cancers, even up to a 100-fold • Easily available and inexpensive / small molecular size Therapeutic Agent : Methotrexate (MTX) • Widely used chemotherapeutic drug for the treatment of a variety of malignancies • Inhibits cytosolic enzyme dihydrofolate reductase (DHFR) • Results in depletion of reduced FA required for nucleotide synthesis • Thus leading to the inhibition of DNA replication and subsequent cell death Fluorescence Tag • Various chemicals : Fluorescein, AlexaFluor • Used for monitoring and tracking Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 13 Difficult to Assemble Multiple Functions onto One Dendrimer • Complex chemistry needed for self-assembly of core and shell dendrimers • No specificity between the coupling of dendrimers Self-Assembly using DNA • Each of two dendrimers carries single-stranded DNA with the same length • DNA strands are complementary • Self-assembly with forming double-stranded DNA • Barbell-shaped, two-dendrimer complexes Fluorescent Dye • Fluorescence can be separated to the other Folate (to receptor) Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 14 Preparation of Each DNA-Dendrimer Conjugate 1. Control surface charge density of amines - By substituting with acetyl groups to prevent infinite network formation due to electrostatic interaction - Acetylation limited to 90% of amines due to densely packed structure - G5 : 12 amine groups / G7 : 108 amine groups 2. Prepare DNA strand - 16-32 nucleotides for spacer from dendrimer / 34 for complementary base pairing 3. EDC/imidazole (0.1M) chemistry used : to activate DNAs for 10mins 4. Slowly mix with LiCl (0.5M) used to weaken electrostatic interactions 5. Allow to react overnight at RT 6. Remove small molecules with membrane filter 7. Purify non-conjugated DNA from using gel electrophoresis 8. Extract purified DNA-dendrimer conjugate from gel 9. Each dendrimer is functionalized : Target, drug and Fluorescence Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 15 Self-assembly 1. Mix two DNA-conjugated G7 and G5 dendrimers in equimolar ratio - to prevent crosslinking and formation of very large complexes 2. Annealing : Heated at 90°C for 10 mins with hybridization buffer 3. Cool at RT for 3 hours G7 G7 G5 G5 Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 16 Does Target Only Cancer Cells, NOT Others? • Targets works to tumor cells PBS (Control) Non-targeted Nanodevice Targeted Nanodevice Only targeted nanodevices taken up • Targets DOES NOT work to other cells PBS (Control) Non-targeted Nanodevice Targeted Nanodevice Spleen cells : no fluorescence In Vivo Experiment : Drug (MTX) Study in Mice Mice received conventional drug Mice received drug in targeted nanodevice • Loss hair / Loss weight (general toxicity) • No tumor reduction unless high dose • Retained hair / No weight loss (Non-toxic) • Necrotic tumors : reduction in size with low dose Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 17 Growth Inhibition to KB Cells Dose-Dependent Inhibition Dose-Dependent Binding of FAs Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 18 • Market Description • Competing Technologies • Valuation and Growth of the aggregate Cancer Therapy Market • Sub-Valuation of the Folate Receptor Targeting Market Market Divisions • Market research into targeted drugs is typically subdivided into passive and active delivery vehicles and cancer and non-cancerous diseases Passive Delivery • Preferential release that exploits structural differences of tumor tissue - Example: microcapsule delivery through highly fenestrated tumor vasculature Active Delivery • Release agents at specific molecular docking sites – Docking sites: Folate receptor (epithelial), RAK1 (breast cancer) Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 20 Hybrid Delivery Systems • Use of large nanovehicles with targeting molecules to penetrate fenestrated vasculature and bind Non-Cancer Targeting • Includes multitude of disease states, where receptor is uniquely or over expressed (Alzheimer's, Parkinson's, Cardio-pulminary diseases, etc.) Cancer Cell Targeting • This is currently the primary focus for targeted drug delivery While Applicable to Four of Market Subdivisions, Multivalent Oligonucleotide – dendrimer Based Delivery Is Primarily Focused on Active Delivery to Tumors Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 21 General Comments on Competing Technologies • Efficacy and reduction of side effects will primarily determine which technologies become adapted for use in treatment • Active targeting technologies are expected to become the next generation cancer therapeutic agent • Search for targets for next generation medications has been slow, folate receptors targets are the most promising Competing Folate Receptor Targeting Technologies • Radiopharmaceutical • Antisense oligonucleotides • Plasmids • Immunotherapeutic agents • Liposomes with entrapped drugs • GNPs Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 22 Overall Valuation • Total cost in 2008 was estimated at $219.2 billion per year, this includes: – Indirect Mortality Costs : $ 112.0 billion – Indirect Morbidity Costs : $ 18.2 billion – Direct Medical Costs : $ 89.0 billion Cancer Pharmaceutical Treatment Market Valuation • From the $ 89.0 billion in direct costs • $ 43.0 billion is was spent on drug therapy Growth • Average rate of cancer treatment market growth from 1963 to 2004 was 10.3% Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 23 Current Revenues for Individual Targeted Therapies • As of 2007, 5 targeted therapies have annual gross revenues each exceeding $1 billion (all of these used passive targeting) Rituxan – Herceptin – Avastin – Eribtux – Gleevec • Total revenues in 2007 for targeted cancer therapies totaled $17.3 billion with a year over year growth rate of 33%. Analysts expect growth rates to slow to 10-11% as non targeted are replaced by targeted • Eight new targeted therapies are expected to also reach blockbuster status (revenues > 1 billion) in 2008-2009 • Typical cost of development and approval for new cancer drugs ranges from $250 million – $1.25 billion, these costs exclude marketing and sales and include failed trials. New targeted therapies have generated extremely high ROI for pharmaceutical companies in recent years. Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 24 Projected Market Share for Targeted Technologies Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 25 Estimated Pharmaceutical Expenditure for FR based Cancers: $ 19 billion/year Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 26 Nano-Vehicular Targeted Cancer Therapy • Expected to Be the Next Generation Cancer Treatment DNA-Linked Dendrimers • Provide Versatility and Controllability to Making Them Strong Candidates for Targeting Vehicles Folate Receptor Mediated Molecular Recognition • Currently the Most Promising Oncological Target Development of Targeted Therapy • Has Proven to Provide Large Returns on Investment with the Potential for Extremely Large Revenue Generation Targeted Nano-Vehicular Cancer Therapy May 11, 2009 EE235 Final Project 27