Enhancing the Safety and Efficacy of Trastuzumab Emtansine (T-DM1) Through Nano-Delivery System in Breast Cancer Therapy

Small. 2024 Dec;20(50):e2400977. doi: 10.1002/smll.202400977. Epub 2024 Oct 6.

Abstract

Trastuzumab emtansine (T-DM1), an antibody-drug conjugate, revolutionizes breast cancer therapy by specifically delivering DM1 to human epidermal growth factor receptor 2 (HER2) overexpressing tumor cells, effectively inhibiting cell division and proliferation. While T-DM1 demonstrates superior efficacy and tolerability, T-DM1-induced thrombocytopenia remains a significant adverse event leading to treatment discontinuation. To address this issue, the study investigates the feasibility of using poly(lactic-co-glycolic acid) (PLGA) nanoparticles as a delivery vehicle to conjugate T-DM1, aiming to alleviate T-DM1-induced thrombocytopenia. The T-DM1-conjugated PLGA nanoparticles (NPs-T-DM1) reduce binding to megakaryocytes without compromising the targeting ability for HER2. Administration of NPs-T-DM1 not only significantly inhibits tumor growth but also reduces damage to megakaryocytes, inhibits T-DM1-induced thrombocytopenia, and remarkably improves the safety of antibody-conjugated drugs. This work presents a promising strategy to enhance the safety and efficacy of T-DM1 in antitumor therapy, offering significant potential for advancing clinical application in HER2-positive breast cancer patients.

Keywords: HER2+ breast cancer; PLGA nanoparticles; T‐DM1; nano‐delivery system; thrombocytopenia.

MeSH terms

  • Ado-Trastuzumab Emtansine* / therapeutic use
  • Animals
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / pathology
  • Cell Line, Tumor
  • Drug Delivery Systems*
  • Female
  • Humans
  • Maytansine / analogs & derivatives
  • Maytansine / therapeutic use
  • Megakaryocytes / drug effects
  • Megakaryocytes / metabolism
  • Mice
  • Nanoparticles* / chemistry
  • Polylactic Acid-Polyglycolic Acid Copolymer / chemistry
  • Receptor, ErbB-2 / metabolism
  • Thrombocytopenia / drug therapy
  • Trastuzumab* / therapeutic use

Substances

  • Ado-Trastuzumab Emtansine
  • Trastuzumab
  • Receptor, ErbB-2
  • Maytansine
  • Polylactic Acid-Polyglycolic Acid Copolymer