Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
  • A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
  • A61L31/04—Macromolecular materials
  • A61L31/042—Polysaccharides
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P35/00—Antineoplastic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system

Definitions

• the present invention relates to the use in the medical-surgical field of biomaterials based on hyaluronic acid derivatives, optionally in association with natural, synthetic or semisynthetic biopolymers, for suppressing the angiogenic process associated with tumour proliferation (in primary and secondary tumours).
• angiogenesis is a dynamic process closely linked with the proliferation of cancer cells, because it is the latter that are chiefly responsible for the production and release of angiogenic factors, such as cytokines and other trophic factors.
• An increase in the vascularisation of a primary tumour can cause an increase in the number of cancer cells that enter into the circulation and give rise to new metastases.
• the anti-CD3 antibody is specific for marking the endothelial cells and therefore enables their identification in the angiogenic process associated with the development of new metastases. Its use has proved essential in assessing the level of microvessel development associated with neoplasia. Indeed, thanks to antibody marking, it is possible to visualise and count the number of interconnections of the vessels within the cancerous tissue to understand and quantify the angiogenic process, relating it to any new developments in the neoplasia (thereby deciding if/how much/how to associate a therapy that modulates or inhibits angiogenesis with an established/classic anticancer therapy.
• One such therapy consists in administering drugs that act by blocking the receptors of the trophic factors (PGDF, bFGF, VEGF) that are also angiogenic factors.
• PGDF trophic factor
• bFGF trophic factor
• VEGF vascular endothelial growth factor
• an anti-angiogenic clinical therapy that provides for a generally oral pharmacological administration in chronic form may have many toxic side effects, because angiogenesis is not only associated with pathological disorders but also physiological processes such as tissue reproduction and repair ⁇ "Cancer: Principle Practice of Oncology" V. De Vita, S. Hellmann and S. Rosenberg, 6 th Edition).
• Hyaluronic acid is one of the chief components of the extracellular matrix of the connective tissue, and there are numerous scientific publications concerning its role in various processes, both physiological and pathological, such as the formation of granulation tissue, chemotaxis in the inflammatory process, cell differentiation for various cell types. Other studies concern its role within the family of "substrate adhesion molecules".
• Hyaluronic acid has been used for the above indications:
• hyaluronic acid enhances cancer cell migration, thereby favouring metastasis, as it is known that the degradation products of hyaluronic acid, that is, oligosaccharides constituted by 10 and 20 oligomers, are strong inducers of the angiogenic process (Hayen et al., J. Cell. Sci. 112, 2241-2251 (1999); Slevin, M. et al., Lab. Invest. 78(8), 987-1003 (1998)).
• biomaterials based on hyaluronic acid and/or the derivatives thereof have never been used as an anti-angiogenic therapy, neither have any other biodegradable and/or non-biodegradable biopolymers ever been used in anticancer therapies.
• the present invention relates to biomaterials based on hyaluronic acid derivatives made into non- woven felts (as the preferred form of biomaterial), optionally in association with natural, synthetic or semisynthetic biopolymers, for use in the medical-surgical field as a new anti-angiogenic therapy ("in situ"), optionally associated with classic pharmacological anticancer therapies and/or radiotherapy, to modulate indirectly the proliferation of tumours, thus blocking the formation of local relapses and, therefore, any new metastases.
• FSC Fusenig silicone chamber
• the cancerous epithelium in the control FSC i.e. without any biomaterial placed under the epithelium
• the layer of granulation tissue underneath had completely replaced the layer of collagen that separated the epithelium from the underlying tissue (Fig. 1).
• the cancerous epithelium in the FSC placed over the Hyaff®-based biomaterial in the form of a non- woven felt is less developed than the relative control, and the layer of collagen that separates it from the nascent granulation tissue underneath is still thick and not infiltrated by cells and/or vessels (Fig. 1).
• the cancer cells After four to six weeks, in the control FSC, the cancer cells have constituted a thick epithelium that penetrates into the thickness of the new granulation tissue underneath, that has already completely replaced the layer of collagen that separated it from the epithelium (Fig. 2).
• the cancerous epithelium is thin but easily distinguishable from the granulation tissue forming over the biomaterial, separated from this tissue by the collagen gel that is still present and not yet absorbed (Fig. 2).
• tumour mass and the granulation tissue have established close contact, but there has been no actual infiltration of tumour cells into the granulation tissue, unlike the control, where the tumour cells have completely invaded the new, underlying granulation tissue (Fig. 2).
• cancerous epithelium can also be visualised with a specific antibody against the protein integrin ⁇ 6.
• Said molecule is, indeed, a component of the hemidesmosomes and its expression is normally only associated with the proliferative area of the epithelial layers.
• Fig. 3a shows that antibody marking for the integrin protein ⁇ 6 is notably present throughout the cancerous epithelium both in the control FCS and in the FCS with the Hyaff®-based biomaterial, even though expression of the test protein appears less extensive throughout the thickness of the cancerous epithelium in the latter sample.
• angiogenic process seems to be at a standstill, no longer enhancing tumour development.
• Vascularisation is limited to the area covered by the Hyaff®-based biomaterial, so the tumour cells do not invade the granulation tissue that has formed within the biomaterial.
• the Hyaff®-based biomaterial proved able to modulate/inhibit the angiogenic process related to vascularisation of the cancerous epithelium. It therefore proves to be particularly advantageous to use the biomaterials based on hyaluronic acid derivatives in the oncological field, where it is important to modulate the angiogenic process and therefore, indirectly, the proliferation of cancer cells in primary and secondary tumours.
• the biomaterials that can be useful in the oncological field as a new anti-angiogenic therapy "in situ" may be, for example, in the form of non-woven felts, sponges, films, membranes, microspheres or in other three-dimensional forms in cases where it is necessary to fill the cavities that are liable to form after surgical removal of a tumour.
• the anti-angiogenic action of the biomaterial can, moreover, be supported by supplementing the biomaterial with NSAIDs, steroids, hormones, antibiotics and especially anti-cancer drugs such as fluorouracil, methotrexate, cis-platinum, carboplatin, oxaliplatin, ethopoxide, cyclophosphamide, vincristine, doxorubicin.

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• Health & Medical Sciences (AREA)
• General Health & Medical Sciences (AREA)
• Veterinary Medicine (AREA)
• Public Health (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• Heart & Thoracic Surgery (AREA)
• Chemical & Material Sciences (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Vascular Medicine (AREA)
• Surgery (AREA)
• Chemical Kinetics & Catalysis (AREA)
• General Chemical & Material Sciences (AREA)
• Medicinal Chemistry (AREA)
• Epidemiology (AREA)
• Organic Chemistry (AREA)
• Pharmacology & Pharmacy (AREA)
• Engineering & Computer Science (AREA)
• Bioinformatics & Cheminformatics (AREA)
• Cardiology (AREA)
• Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
• Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
• Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)

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• 2002
  • 2002-01-11 IT IT2002PD000003A patent/ITPD20020003A1/it unknown
• 2003
  • 2003-01-07 AT AT03700315T patent/ATE448809T1/de active
  • 2003-01-07 WO PCT/EP2003/000078 patent/WO2003057203A2/en not_active Ceased
  • 2003-01-07 US US10/501,030 patent/US7838510B2/en not_active Expired - Lifetime
  • 2003-01-07 DK DK03700315.9T patent/DK1463541T3/da active
  • 2003-01-07 AU AU2003201618A patent/AU2003201618B2/en not_active Ceased
  • 2003-01-07 ES ES03700315T patent/ES2334497T3/es not_active Expired - Lifetime
  • 2003-01-07 CA CA2472880A patent/CA2472880C/en not_active Expired - Lifetime
  • 2003-01-07 PT PT03700315T patent/PT1463541E/pt unknown
  • 2003-01-07 DE DE60330113T patent/DE60330113D1/de not_active Expired - Lifetime
  • 2003-01-07 EP EP03700315A patent/EP1463541B1/en not_active Expired - Lifetime
  • 2003-01-07 JP JP2003557561A patent/JP4603263B2/ja not_active Expired - Lifetime

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