(12) United States Patent (10) Patent No.: US 7,371.225 B2 Oldfield Et Al
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USOO7371225B2 (12) United States Patent (10) Patent No.: US 7,371.225 B2 Oldfield et al. (45) Date of Patent: May 13, 2008 (54) METHOD FOR CONVECTION ENHANCED 5,720,720 A * 2/1998 Laske et al. ................ 604,500 DELIVERY OF THERAPEUTIC AGENTS 5,882,626 A 3/1999 Epstein et al. 6,435,714 B1 8, 2002 Bruder (75) Inventors: Edward H. Oldfield, Philomont, VA 6,438,198 B1 8/2002 Kohler (US); Russel R. Lonser, Silver Spring, 6,442,229 B1 8, 2002 Koehler et al. MD (US); Kayhan Garmestani, FOREIGN PATENT DOCUMENTS Potomac, MD (US); Martin W. EP O 882 454 A3 12, 1998 Brechbiel, Annandale, VA (US) WO WO 93,06868 4f1993 (73) Assignee: The United States of America as OTHER PUBLICATIONS represented by the Secretary of the . Department of Health and Human Laske et al. 1997, Tumor regression with regional distribution of the targeted toxin TF-CRM100 in patients with malignant brain tumors. Services, Washington, DC (US) Nature Medicine 3(12): 1362-1368.* - r Kobayashi et al. Jul. 1, 2001; Dynamic micro-magnetic resonance (*) Notice: Subject to any disclaimer, the term of this imaging of liver micro-metastasis in mice with a novel liver patent is extended or adjusted under 35 macromolecular magnetic resonance contrast agent DAB-AM64 U.S.C. 154(b) by 257 days. (1B4M-Gd)64. Cancer Research 61: 4966-4970.* Krollet al. 1996; Increasing volume of distribution to the brain with (21) Appl. No.: 10/528,310 interstitial infusion: Dose, rather than convection, might be the most important factor. Neurosurgery 38(4): 746-752.* (22) PCT Filed: Sep. 24, 2003 Lonser et al. 1998; Direct convective delivery of macromolecules to the spinal cord. J. Neurosurgery 89: 616-622.* (86). PCT No.: PCT/USO3/30.155 Wisneski et al. 1985; Absence of myocardial biochemical toxicity with a non ioninc contrast agentiopamidol. American Heart Journal S 371 (c)(1), Wosilait110 A. re,et al. 1981; only Competition the E. between being EE,serum albumin and (2), (4) Date: Mar. 17, 2005 soluble fraction of liver for binding of warfarin and other drugs. Res (87) PCT Pub. No.: WO2004/031348 M". inst Pharamcol. 32(1): 113-122; only the Bobo et al., Proc. Natl. Acad. Sci. USA 91:2076-2080, 1994. PCT Pub. Date: Apr. 15, 2004 Chen et al., J. Neurosurg 90:315-320, 1999. Debinski, Cancer Invest 2005-6):801-809, 2002 (Abstract). (65) Prior Publication Data US 2006/OO73101 A1 Apr. 6, 2006 (Continued) Primary Examiner Karen Cochrane Carlson Related U.S. Application Data (74) Attorney, Agent, or Firm—Klarduist Sparkman, LLP (60) gyal application No. 60/413,673, filed on Sep. (57) ABSTRACT A method for monitoring and controlling convection (51) Estoo (2006.01) enhanced delivery of a therapeutic agent to a target tissue is disclosed. A tracer that is detectable, for example, by mag (52) U.S. Cl. ...................................... ... 604/49 netic resonance imaging (MRI) and/or by X-ray computed (58) Field of Classification Search .................. 604/49; tomography (CT) is co-infused with the therapeutic agent A61 M 3 I/OO and used to monitor the distribution of the therapeutic agent See application file for complete search history. as it moves through the target tissue. The images obtained (56) References Cited during delivery are used to confirm delivery of the thera peutic agent to the target tissue and to avoid exposure of U.S. PATENT DOCUMENTS tissue outside of the targeted area to the therapeutic agent. In addition, the signal intensity of the images may be used to 4,339.426 A 7, 1982 Meares et al. 5,093,042 A 3, 1992 Counsell et al. confirm that the therapeutic agent has been delivered to the 5,415,867 A 5/1995 Minchey et al. target tissue at a desired concentration. 5,514,379 A * 5, 1996 Weissleder et al. ......... 424/426 5,660,814 A * 8/1997 Uggeri et al. .............. 424,936 29 Claims, 14 Drawing Sheets US 7,371.225 B2 Page 2 OTHER PUBLICATIONS Dendrimer Core With Reference to Their Pharmacokinetic Proper ties.” Magnetic Resonance in Medicine 45:454-460, 2001. Guridi et al., J. Neurosurg. 93:364-366, 2000. Kobayashi et al., “Dynamic Micro-Magnetic Resonance Imaging of Hall, Neurosurgery 46(3):544-551, 2000 (Abstract). Liver Micrometastasis in Mice with a Novel Liver Macromolecular Hamilton et al., Experimental Neurology 168: 155-161, 2001. Magnetic Resonance Contrast Agent DAB-Amó4-(1B4M-Gd).” Kobayashi et al., “Monoclonal antibody-dendrimer conjugates Cancer Research 61:4966-4970, 2001. enable radiolabeling of antibody with markedly high specific activ Kobayashi et al., “Novel Intravascular Macromolecular MRI Con ity with minimal loss of immunoreactivity,” http://link. Springer-ny. trast Agent With Generation-4 Polyamidoamine Dendrimer Core: com/link? service/journals/00259/contents/00/00293/ Accelerated Renal Excretion With Coinjection of Lysine.” Magnetic s002590000293ch002.htm, downloaded Jun. 22, 2001 (Abstract). Resonance in Medicine 46:457-464, 2001. Laske et al., J. Neurosurg 80:520-526, 1994. Kobayashi et al., “Novel Liver Macromolecular MR Contrast Agent Laske et al., J. Neurosurg 87:586-594, 1997. With a Polypropylenimine Diaminobutyl Dendrimer Core: Com Laske et al., Nature Medicine 3(12): 1362-1368, 1997. parison to the Vascular MR Contrast Agent With the Lieberman et al., J. Neurosurg, 82:1021-1029, 1995. 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Macromolecules in CT and MRI via Convection Enhanced Deliv Physiol. 46):R1218-R1229, 1999. ery,” presented in a non-public forum to employees of the National Nguyen et al., J. Neurosurg, 98(3):584-590, 2003 (Abstract). Institutes of Health, Summer 1998. Oldfield et al., Curr: Top. Microbiol. Immunol. 234:97-114, 1998. Malik et al., “Dendrimer-platinate: a novel approach to cancer Ratliff et al., J. Neurosurg.95:1001-1011, 2001. chemotherapy,” Anti-Cancer Drugs 10:767-776, 1999. Wood et al., J. Neurosurg (Spine I), 90:115-120, 1999. Sato et al., “Pharmacokinetics and Enhancement Patterns of X-ray Transmission Imaging,” http://cfi.lbl.gov/-budinger/ Macromolecular MR Contrast Agent With Various Sizes of medTechdocs/Xray.html, downloaded Sep. 20, 2002. Polyamidoamine Dendrimer Cores.” Magnetic Resonance in Medi Zirzow et al., Neurochemical Research 24(2):301-305, 1999. cine 46:1169-1173, 2001. Caravan et al., “Gadolinium(III) Chelates as MRI Contrast Agents: Tajarobi et al., “Transport of poly amidoamine dendrimers across Structure, Dynamics, and Applications.” Chem. Rev., pp. 2293 Madin-Darby canine kidney cells.” International Journal of 2352, 1999. Pharmaceutics 215:263-267, 2001. Eichman et al., “Imaging of gold dendrimer nanocomposites in “Monitoring Infusion of Protein into Brain by Computed cells.” Mat. Res. Soc. Symp. Proc. 676:Y9.3.1-Y9.3.11, 2001. Tomography.” NIH Bioengineering Symposium, Feb. 1998. Kobayashi et al., “3D-Micro-MR Angiography of Mice Using Macromolecular MR Contrast Agents With Polyamidoamine * cited by examiner U.S. Patent May 13, 2008 Sheet 1 of 14 US 7,371.225 B2 FIG. U.S. Patent May 13, 2008 Sheet 2 of 14 US 7,371.225 B2 e U.S. Patent May 13 , 2008 Sheet 3 of 14 US 79 371.225 B2 U.S. Patent May 13, 2008 Sheet 4 of 14 US 7,371.225 B2 1200 1000 8OO 600 400 200 O 20 40 6O 80 100 120 140 Volume of infusion (microliters) FIG. 4 U.S. Patent May 13, 2008 Sheet 5 of 14 US 7,371.225 B2 20 18 16 14 1 2 O 20 40 60 80 100 120 Volume of infusion (microliters) FGS U.S. Patent May 13, 2008 Sheet 6 of 14 US 7,371.225 B2 FIG. 6 U.S. Patent May 13, 2008 Sheet 7 of 14 US 7,371.225 B2 300 250 E E 2OO 150 V 100 50 O O 2 4, 6 8 10 12 14 16 Distance (millimeters) FG. 7 U.S. Patent May 13, 2008 Sheet 8 of 14 US 7,371.225 B2 1600 1400 () S. 1200 9 5o 1OOO 9 S2 800 s 600 O C 400 E DO 200 O O 1 2 Post-infusion day FG. 8 U.S. Patent May 13, 2008 Sheet 9 of 14 US 7,371.225 B2 F.G. 9 U.S. Patent May 13, 2008 Sheet 10 of 14 US 7,371.225 B2 F.G. 10 U.S. Patent May 13, 2008 Sheet 11 of 14 US 7,371.225 B2 F.G. 11 U.S. Patent May 13, 2008 Sheet 12 of 14 US 7,371.225 B2 F.G. 12 U.S. Patent May 13, 2008 Sheet 13 of 14 US 7,371.225 B2 U.S. Patent May 13, 2008 Sheet 14 of 14 US 7,371.225 B2 2 1 OO O 9 BOO FOO O SOC AO) 3OO 2OO O O 5 2O 25 3O 35 AO 45 SO 55 30 35 lodins (mg/ml) FIG.