Targeting single-walled carbon nanotubes for the treatment of breast cancer using photothermal therapy

To develop a therapeutic system with cancer cell selectivity, the present study evaluated a possible specific and localized tumor treatment. Phosphatidylserine (PS) exposure on the external face of the cell membrane is almost completely exclusive to cancer cells and endothelial cells in the tumor vasculature. The human protein annexin V is known to have strong calcium-dependent binding to anionic phospholipids such as PS. This protein was studied for targeting single-walled carbon nanotubes (SWNTs) to the vasculature of breast tumors.;The synthesis of the protein annexin V, by a pET vector in Escherichia coli, constitutes the first phase of this study. Recombinant annexin V was purified from the cell lysate supernatant by immobilized metal affinity chromatography. The overall production of purified annexin V protein was 50 mg/L.;The binding ability of the protein annexin V was evaluated by determining the dissociation constant when incubated with proliferating human endothelial cells in vitro. The dissociation constant, Kd, was measured to be 0.8 nM, indicating relatively strong binding. This value of Kd is within the range reported in the literature.;Single-walled carbon nanotubes (SWNTs) were functionalized with annexin V using two intermediate linkers (containing FMOC and DSPE) resulting in stable suspensions. The SWNT and protein concentrations were 202 mg/L and 515 mg/L, respectively, using the linker with DSPE (average of nine preparations). The conjugation method that used the DSPE-PEG-maleimide linker allowed to successfully conjugate the SWNTs with final concentrations approximately five times higher than the linker containing FMOC. The conjugation method used has a non-covalent nature, and therefore the optical properties of the nanotubes were preserved.;The conjugate was also visually observed using atomic force microscopy (AFM), allowing to verify the presence of the protein annexin V on the surface of the nanotubes, with an height ranging between 2.5 to 5.0 nm. Confocal microscopy was used to prove the binding of the conjugates to human endothelial cells grown in vitro.;Proliferating endothelial cells were used to determine the optimal near-infrared (NIR) laser irradiation settings (energy density = 200 J/cm2), which would not induce cell cytotoxicity from the laser itself. A 2 hour incubation with the conjugate followed by a washing step and NIR irradiation (wavelength = 980 nm, power = 1 W/cm2, time = 200 seconds) was enough to induce significant cell death (≈55 %), without significant damage to the control samples.;Administration of the same conjugates i.v. in Balb/cJ female mice resulted in detectable accumulation of the SWNTs in the tumor tissues, with minimal retention in the kidneys 24 hours post-administration. A dosage of 0.82 mg/kg of SWNTs administered i.v. and followed one day later by a NIR irradiation (wavelength = 980 nm, power = 1 W/cm2, time = 175 seconds) led to complete disappearance of implanted 4T1 mouse mammary tumors for the majority of the animals from the treatment groups, within a few days. The combination of the photothermal therapy with a low dosage (50 mg/kg) of the immunoadjuvant cyclophosphamide, given 2 days before NIR irradiation, was also evaluated; this resulted in increased survival. Histological findings revealed the complete obliteration of the tumors treated from the original site, with complete regeneration of the skin epithelial layer and absence of cancer cells.;In conclusion, this research was successful in demonstrating that SWNTs could be targeted to the tumor vasculature in vivo and then could be heated by NIR irradiation to completely kill mouse mammary tumors implanted in immune-competent mice. There is evidence that the co-administration of the immunostimulant cyclophosphamide caused increased survival of the mice. It is recommended that future work be directed to exploring methods to increase the concentration of the SWNT-annexin V conjugate in the tumor and to evaluate the co-administration of other immunostimulants, either alone or in combination.