Clinical perspectives for the use of new hypoxic cell sensitizers

Journal Article · Wed Sep 01 04:00:00 EDT 1982 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(82)90608-3· OSTI ID:6866120

Brown, J M

Experience with high pressure oxygen in combination with radiotherapy has shown that, for some tumors at least, the presence of hypoxic cells is a limiting factor in the ability to cure these tumors even with conventional daily fractionation. This suggests that hypoxic cell radiosensitizers, of which misonidazole (MISO) is the prototype drug, may play a role in improving the cure-rate of some tumors when combined with daily fractionation. Even for those tumors for which no improvement is seen when combined with daily fractionation, it is likely that there will be an important role for these sensitizers by using them in combination with regimens of only a few dose fractions. Because of the limiting side effects of neuropathy, a less toxic radiosensitizer than MISO is required to gain the full clinical benefit of these drugs. A possible way of achieving this is to reduce the lipid solubility (lipophilicity) of the compounds while still retaining their electron-affinity. This reduces the concentration of drug in the neural tissues (brain, peripheral nerves) without affecting the tumor concentration. However, if the lipophilicity is too low, the drugs are unable to enter the hypoxic cells and hence lose their radiosensitivity efficiency. It would appear that a lipophilicity given by an octanol:water partition coefficient of approximately 0.04 is optimum (cf. MISO = 0.43) with the 2-nitroimidazole amide SR-2508 the best in this series. Tumor levels of this drug of at least 7-8 times those obtained with MISO should be attainable clinically for no increase in neurotoxicity. Another property of electron-affinic sensitizers shows clinical promise. This is their ability to preferentially sensitize tumors compared to normal tissues to the cytotoxic action of several chemotherapeutic agents.

• Research Organization: Stanford Univ., CA
• OSTI ID: 6866120
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 8:9; ISSN IOBPD
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ALKYLATING AGENTS
ANOXIA
ANTINEOPLASTIC DRUGS
AZOLES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
DRUGS
ELEMENTS
ENDOXAN
FRACTIONATED IRRADIATION
HETEROCYCLIC COMPOUNDS
IMIDAZOLES
IMMUNOSUPPRESSIVE DRUGS
IRRADIATION
MEDICINE
MISONIDAZOLE
NERVOUS SYSTEM
NONMETALS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
OXYGEN
RADIATION EFFECTS
RADIOLOGY
RADIOSENSITIVITY EFFECTS
RADIOSENSITIZERS
RADIOTHERAPY
THERAPY