Polyglutamate-based nanoconjugates for image-guided surgery and post-operative melanoma metastases prevention

Yana Epshtein, Rachel Blau, Evgeni Pisarevsky, Shani Koshrovski-Michae, Dikla Ben-Shusha, Sabina Pozzi, Gal Shenbach-Kolti, Lidar Fridrich, Marina Buzhor, Adva Krivitsky, Pradip Dey, Ronit Satchi-Fainar

Research output: Contribution to journalArticlepeer-review

Abstract

Rationale: Cutaneous melanoma is the most aggressive and deadliest of all skin malignancies. Complete primary tumor removal augmented by advanced imaging tools and effective post-operative treatment is critical in the prevention of tumor recurrence and future metastases formation. Methods: To meet this challenge, we designed novel polymeric imaging and therapeutic systems, implemented in a two-step theranostic approach. Both are composed of the biocompatible and biodegradable poly(α,L-glutamic acid) (PGA) nanocarrier that facilitates extravasation-dependent tumor targeting delivery. The first system is a novel, fluorescent, Turn-ON diagnostic probe evaluated for the precise excision of the primary tumor during image-guided surgery (IGS). The fluorescence activation of the probe occurs via PGA degradation by tumor-overexpressed cathepsins that leads to the separation of closely-packed, quenched FRET pair. This results in the emission of a strong fluorescence signal enabling the delineation of the tumor boundaries. Second, therapeutic step is aimed to prevent metastases formation with minimal side effects and maximal efficacy. To that end, a targeted treatment containing a BRAF (Dabrafenib - mDBF)/MEK (Selumetinib - SLM) inhibitors combined on one polymeric platform (PGA-mDBF-SLM) was evaluated for its anti-metastatic, preventive activity in combination with immune checkpoint inhibitors (ICPi) αPD1 and αCTLA4. Results: IGS in melanoma-bearing mice led to a high tumor-to-background ratio and reduced tumor recurrence in comparison with mice that underwent surgery under white light (23% versus 33%, respectively). Adjuvant therapy with PGA-SLM-mDBF combined with ICPi, was well-tolerated and resulted in prolonged survival and prevention of peritoneal and brain metastases formation in BRAF-mutated melanoma-bearing mice. Conclusions: The results reveal the great clinical potential of our PGA-based nanosystems as a tool for holistic melanoma treatment management.

Original languageEnglish
Pages (from-to)6339-6362
Number of pages24
JournalTheranostics
Volume12
Issue number15
DOIs
StatePublished - 2022

Keywords

  • BRAF/MEK inhibitors
  • Image-guided surgery
  • Immune checkpoint inhibitors
  • PGA
  • Polymeric nanomedicine

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