WO2018022929A1 - Composé pour radiothérapie. - Google Patents

Composé pour radiothérapie. Download PDF

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Publication number
WO2018022929A1
WO2018022929A1 PCT/US2017/044237 US2017044237W WO2018022929A1 WO 2018022929 A1 WO2018022929 A1 WO 2018022929A1 US 2017044237 W US2017044237 W US 2017044237W WO 2018022929 A1 WO2018022929 A1 WO 2018022929A1
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WO
WIPO (PCT)
Prior art keywords
avidin
talc
composition
cancer
radioisotope
Prior art date
Application number
PCT/US2017/044237
Other languages
English (en)
Inventor
Robert N. TAUB
Lubov A. PETRUKHIN
Gleneara E. BATES
Original Assignee
The Trustees Of Columbia University In The City Of New York
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by The Trustees Of Columbia University In The City Of New York filed Critical The Trustees Of Columbia University In The City Of New York
Priority to EP17835299.3A priority Critical patent/EP3490615A4/fr
Publication of WO2018022929A1 publication Critical patent/WO2018022929A1/fr
Priority to US16/255,460 priority patent/US20190216956A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/335—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin
    • A61K31/337—Heterocyclic compounds having oxygen as the only ring hetero atom, e.g. fungichromin having four-membered rings, e.g. taxol
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00—Medicinal preparations containing inorganic active ingredients
    • A61K33/24—Heavy metals; Compounds thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/33—Heterocyclic compounds
    • A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/40—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil
    • A61K31/407—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with one nitrogen as the only ring hetero atom, e.g. sulpiride, succinimide, tolmetin, buflomedil condensed with other heterocyclic ring systems, e.g. ketorolac, physostigmine
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00—Medicinal preparations containing organic active ingredients
    • A61K31/70—Carbohydrates; Sugars; Derivatives thereof
    • A61K31/7028—Compounds having saccharide radicals attached to non-saccharide compounds by glycosidic linkages
    • A61K31/7034—Compounds having saccharide radicals attached to non-saccharide compounds by glycosidic linkages attached to a carbocyclic compound, e.g. phloridzin
    • A61K31/704—Compounds having saccharide radicals attached to non-saccharide compounds by glycosidic linkages attached to a carbocyclic compound, e.g. phloridzin attached to a condensed carbocyclic ring system, e.g. sennosides, thiocolchicosides, escin, daunorubicin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00—Medicinal preparations containing inorganic active ingredients
    • A61K33/24—Heavy metals; Compounds thereof
    • A61K33/242—Gold; Compounds thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00—Medicinal preparations containing inorganic active ingredients
    • A61K33/24—Heavy metals; Compounds thereof
    • A61K33/243—Platinum; Compounds thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K33/00—Medicinal preparations containing inorganic active ingredients
    • A61K33/24—Heavy metals; Compounds thereof
    • A61K33/244—Lanthanides; Compounds thereof
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/04—Peptides having up to 20 amino acids in a fully defined sequence; Derivatives thereof
    • A61K38/14—Peptides containing saccharide radicals; Derivatives thereof, e.g. bleomycin, phleomycin, muramylpeptides or vancomycin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
    • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/51—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent
    • A61K47/62—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being a protein, peptide or polyamino acid
    • A61K47/66—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being a protein, peptide or polyamino acid the modifying agent being a pre-targeting system involving a peptide or protein for targeting specific cells
    • A61K47/665—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the non-active ingredient being a modifying agent the modifying agent being a protein, peptide or polyamino acid the modifying agent being a pre-targeting system involving a peptide or protein for targeting specific cells the pre-targeting system, clearing therapy or rescue therapy involving biotin-(strept) avidin systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/69—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit
    • A61K47/6903—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being semi-solid, e.g. an ointment, a gel, a hydrogel or a solidifying gel
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/69—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit
    • A61K47/6921—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being a particulate, a powder, an adsorbate, a bead or a sphere
    • A61K47/6923—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being a particulate, a powder, an adsorbate, a bead or a sphere the form being an inorganic particle, e.g. ceramic particles, silica particles, ferrite or synsorb
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/50—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates
    • A61K47/69—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit
    • A61K47/6921—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being a particulate, a powder, an adsorbate, a bead or a sphere
    • A61K47/6927—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being a particulate, a powder, an adsorbate, a bead or a sphere the form being a solid microparticle having no hollow or gas-filled cores
    • A61K47/6929—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient the non-active ingredient being chemically bound to the active ingredient, e.g. polymer-drug conjugates the conjugate being characterised by physical or galenical forms, e.g. emulsion, particle, inclusion complex, stent or kit the form being a particulate, a powder, an adsorbate, a bead or a sphere the form being a solid microparticle having no hollow or gas-filled cores the form being a nanoparticle, e.g. an immuno-nanoparticle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K51/00—Preparations containing radioactive substances for use in therapy or testing in vivo
    • A61K51/02—Preparations containing radioactive substances for use in therapy or testing in vivo characterised by the carrier, i.e. characterised by the agent or material covalently linked or complexing the radioactive nucleus
    • A61K51/04—Organic compounds
    • A61K51/0495—Pretargeting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K51/00—Preparations containing radioactive substances for use in therapy or testing in vivo
    • A61K51/12—Preparations containing radioactive substances for use in therapy or testing in vivo characterised by a special physical form, e.g. emulsion, microcapsules, liposomes, characterized by a special physical form, e.g. emulsions, dispersions, microcapsules
    • A61K51/1213—Semi-solid forms, gels, hydrogels, ointments, fats and waxes that are solid at room temperature

Definitions

  • kits, compositions, or methods for the treatment of a disease, disorder, or condition such as a proliferative disease, disorder, or condition, including therapeutic compositions that are unbound or bound to a gel substrate.
  • MPM Malignant pleural mesothelioma
  • a common cause of MPM is exposure to asbestos (a silicate mineral), and although asbestos use has decreased, the cases of MPM is expected to rise.
  • MPM can present as a pleural effusion or as localized plaque-like pleural lesions.
  • Pleural effusion a condition where liquid buildup in between lung walls leads to shortness of breath, affects 95% of MPM patients.
  • MPM is conventionally treated by stripping of the pleura if possible followed by evacuation of the effusion by suction and injecting a solution of talc particles into the residual cavity to inflame the surfaces, thereby allowing the parietal and visceral pleura to adhere to each other, closing the cavity and preventing the recurrence of the effusion.
  • Follow-up treatment includes systemic
  • cancerous cells e.g., free-floating persistent microscopic tumor cells.
  • these follow-up treatments are not selective in their targeting or may not penetrate into the now poorly vascularized, inflamed, tumor-contaminated pleural space or pleurodesed surfaces. Recurrence of tumors from cancerous cells left behind can be a common outcome.
  • kits, a method, and a composition for treatment of a proliferative disease, disorder, or condition can include a radioisotope and a substrate, In some embodiments, the radioisotope is contained in or on the substrate and the substrate includes a gelatin matrix.
  • proliferative disease, disorder, or condition comprises a first composition comprising a ligand coupled to a substrate; and a second composition comprising a receptor coupled to a radioisotope.
  • the combination of the first composition and the second composition forms a substrate coupled to a radioisotope via ligand-receptor binding.
  • the first composition is administered to the subject post-operatively to a target tissue or in a cavity where proliferative cells or tissue were surgically removed.
  • the first composition or the second composition is administered in an amount effective to inhibit replication of cancer cells; inhibit spread of the proliferative disease, disorder, or condition; reduce tumor size; decrease tumor vascularization; increase tumor permeability; reduce recurrence of tumor growth; prevent recurrence of tumor growth; reduce a number of cancerous cells in the subject; or ameliorate a symptom of the disease, disorder, or condition.
  • the substrate coupled to a radioisotope is administered to a bladder of a subject or to abraded tissue or glued with fibrin glue or cyanoacrylate or some other material that couples, binds, attaches, or adheres the substrate to the bladder wall.
  • the substrate coupled to a radioisotope is administered to a subject in an effective amount to modulate radiation exposure, control depth of exposure, control extension of exposure, including, for example, radial extension of exposure, or lateral extension of exposure.
  • the ligand includes streptavidin, streptavidin variant, avidin, avidin variant, PEGylated ligand, or molecularly imprinted polymer.
  • the ligand includes the receptor comprising a biotin.
  • the substrate including a gelatin matrix includes a gelatin, a gelfoam, a gelfoam pad, a gelfoam strip, a gelfoam mesh, a gelfoam paste, or a gelfoam tile, or combinations thereof.
  • the substrate comprises multiple layers, wherein the multiple layers are placed to modulate radiation exposure, control depth of exposure, or control extension of exposure, including, for example, radial extension of exposure, or lateral extension of exposure.
  • the substrate coupled to a radioisotope comprises radiopaque particles or materials.
  • the substrate is formed in a tile shape, wherein the placement of the tiles modulate radioactive dose or cover a target tissue.
  • the substrate or substrate coupled to a radioisotope are stacked or layered to modulate radioactive dose; impregnated with
  • radiopaque material tiled to cover a larger area; cut into irregular shape to accommodate the shape or size of a target tissue; offset or spaced from the target area, by a predetermined distance or spacing; or combinations thereof.
  • the substrate is coupled to a radioisotope via ligand-receptor binding and placed in proximity to a target tissue associated with the proliferative disease, disorder, or condition such that radioisotope coupled to the substrate can administer a therapeutic dose to the target tissue.
  • the substrate is coupled to a radioisotope via ligand-receptor binding and is placed in proximity to a target tissue
  • radioisotope coupled to the substrate can administer a therapeutic dose to the target tissue.
  • the ligand includes specific or non-specific affinity for the receptor or a streptavidin, streptavidin variant, avidin, avidin variant, PEGylated ligand, or molecularly imprinted polymer.
  • the receptor includes biotin.
  • the gelatin matrix includes a gelatin, a gelfoam, a gelfoam pad, a gelfoam strip, a gelfoam mesh, a gelfoam paste, a gelfoam tile, or combinations thereof.
  • the radioisotope includes lutetium-177, yttrium-90, iodine-131 , phosphorus-32, boron-10, radium-223, bismuth-213, lead-212, holmium-166, dysprosium- 165, erbium-169, iodine-125, iridium-192, rhenium-186, rhenium-188, samarium-153, strontium-89, a cesium radioisotope, a gold radioisotope, or a ruthenium radioisotope.
  • the radioisotope is selected from one or more of a chelated radioisotope, an unchelated radioisotope, a radioisotope microparticles, or a radioisotope nanoparticles.
  • the radioisotope is encapsulated in biotinylated latex material or admixed and dispersed into an avidin-gelatin matrix.
  • the disease, disorder, or condition includes one or more selected from the group consisting of: a cancer, malignant pleural mesothelioma, peritoneal carcinomatosis, leukemia, lymphoma, non-small cell lung cancer, testicular cancer, lung cancer, abdominal cancer, ovarian cancer, uterine cancer, cervical cancer, pancreatic cancer, gastrointestinal cancer, colorectal cancer, breast cancer, prostate cancer, gastric cancer, colon cancer, skin cancer, stomach cancer, liver cancer, liver metastasis, esophageal cancer, bladder cancer, appendiceal carcinoma, gastric carcinoma, pancreatic carcinoma, peritoneal mesothelioma, pseudomyxoma peritonei, blood vessel proliferative disorder, fibrotic disorder, mesangial cell proliferative disorder, psoriasis, actinic keratoses, seborrheic keratoses, warts, keloid scars, eczema, viral
  • pseudomyxoma peritonei prostate cancer, prostate cancer lymph node dissection beds, rectovesical pouch tumor bed, ovarian cancer resection bed and peritoneal spread, uterine cancer resection cavities, pleural and peritoneal mesothelioma resection bed and peritoneal seeding, kidney cancer, gastrointestinal cancer, colorectal carcinoma, appendiceal
  • carcinoma pancreatic carcinoma, liver metastases, gastric carcinoma, renal carcinoma, retroperitoneal tumors, retroperitoneal sarcoma, retroperitoneal carcinoma, breast cancer, breast cancer lumpectomy, breast cancer lumpectomy dissection cavity, breast cancer lymph node, breast cancer lymph node dissection cavity, melanoma, melanoma node dissection cavity, sarcoma, sarcoma resection cavities, head or neck cancer, head or neck cancer resection cavity, neck cancer lymph node, neck lymph node dissection cavities, scalp lesion, glioblastoma, glioblastoma resection cavity, brain surface tumor lesion, resected brain surface tumor lesion, non resected brain surface tumor lesion, trunk sarcoma, trunk sarcoma resection cavity, extremity sarcoma, and extremity sarcoma resection cavity, or a
  • the proliferative disease, disorder, or condition includes a cancer.
  • FIG. 1A - FIG. 2J are a series of microscopy images depicting the binding capacity of proteins to Talc using a FITC filter and a Rhodamine filter.
  • FIG. 1A shows Biotin Rhodamine binding to talc.
  • FIG. 1 B shows Anti-Avidin FITC binding to talc.
  • FIG. 2A -FIG. 2J are a series of microscopy images depicting Avidin and Avidin
  • FIG. 2A shows 100 ⁇ Avidin and Avidin Rhodamine in reaction after washing with 3x with 1 ml 1x PBS.
  • FIG. 2B shows 100 ⁇ Avidin and Avidin Rhodamine in reaction after washing with 3x with 1 ml 1x PBS followed by washing 3x with 0.2% EDTA.
  • FIG. 2C shows 10 ⁇ Avidin and Avidin Rhodamine after washing with 3x with 1 ml 1x
  • FIG. 2D shows 10 ⁇ Avidin and Avidin Rhodamine after washing with 3x with 1 ml 1x PBS followed by washing 3x with 0.2% EDTA (0.5 ml).
  • FIG. 2E shows 1 ⁇ Avidin and Avidin Rhodamine after washing with 3x with 1 ml 1x
  • FIG. 2F shows 1 ⁇ Avidin and Avidin Rhodamine after washing with 3x with 1 ml 1x PBS followed by washing 3x with 0.2% EDTA.
  • FIG. 2G shows 100 nM Avidin and Avidin Rhodamine after washing with 3x with 1 ml 1x PBS.
  • FIG. 2H shows 100 nM Avidin and Avidin Rhodamine after washing with 3x with 1 ml 1x PBS followed by washing 3x with 0.2% EDTA.
  • FIG. 2J shows 10 nM Avidin and Avidin Rhodamine after washing with 3x with 1 ml 1x PBS followed by washing 3x with 0.2% EDTA.
  • FIG. 3 is a scatter plot depicting the saturation amount of Avidin with 100 mg talc.
  • FIG. 4 is a scatter plot depicting the amount of Avidin removed from the surface of talc during wash.
  • FIG. 6 is a scatter plot depicting Avidin bound to the surface of talc.
  • FIG. 7 are a series of flow cytometry data for FITC and Rhodamine labeled talc.
  • FIG. 8B shows Optical Density (OD) values for HRP Avidin at varying concentrations.
  • FIG. 9A shows Optical Density (OD) values for HRP Avidin remaining in supernatant following overnight incubation with talc.
  • FIG. 9B shows Optical Density (OD) values for HRP Avidin at varying concentrations.
  • FIG. 10 are a series of flow cytometry data for bleomycin and talc at various excitation and emission wavelengths.
  • FIG. 12 are a series of flow cytometry data for bleomycin and talc at various excitation and emission wavelengths (repeated study).
  • FIG. 13 is a scatter plot depicting % survival NCI-28H cells after incubation for 72 hrs with talc and talc bound to bleomycin.
  • FIG. 14 is a scatter plot depicting % survival NCI-28H cells after 72 hours of bleomycin treatment.
  • FIG. 15 are a series of flow cytometry data for washed samples of bleomycin and talc at various excitation and emission wavelengths.
  • FIG. 16 is a scatter plot depicting % NCI-28H cells survival after 72 hours of doxorubicin treatment.
  • FIG. 17 is a bar graph of % NCI-28H cells survival after various treatments.
  • FIG. 18 is a scatter plot depicting % NCI-28H cells survival after 72 hours of exposure to cisplatin.
  • FIG. 19 is the data and a bar graph showing the comparison of survival NCI-28H cells with different treatments.
  • FIG. 20 is the data and a bar graph showing the comparison of survival NCI-28H cells with different treatments.
  • FIG. 22 is a scatter plot depicting % NCI-28H cells survival after exposure to talc or talc bound to paclitaxel.
  • FIG. 23 is the data and a bar graph showing the comparison of survival NCI-28H cells with different treatments.
  • FIG. 24 is a scatter plot depicting % NCI-28H cells survival after exposure to carboplatin.
  • FIG. 25 is a scatter plot depicting % NCI-28H cells survival after 72 hours exposure to talc or talc/carboplatin.
  • FIG. 26 is the data and a bar graph showing the comparison of survival NCI-28H cells with different treatments.
  • FIG. 27 is a scatter plot depicting % NCI-28H cells survival after 72 hours exposure to mitomycin.
  • FIG. 28 is a scatter plot depicting % NCI-28H cells survival after exposure to talc or talc bound to mitomycin.
  • FIG. 29 is a scatter plot depicting % NCI-28H cells survival after 72 hours exposure to talc or talc bound to gemcitabine.
  • FIG. 30 is a scatter plot depicting % NCI-28H cells survival after 72 hours exposure to talc or talc bound to gemcitabine.
  • FIG. 31 is a scatter plot depicting % NCI-2052H cells survival after 72 hours exposure to bleomycin.
  • FIG. 33 is the data and a bar graph showing the comparison of survival NCI-2052H cells with different treatments.
  • FIG. 34 is a scatter plot depicting % NCI-2052H cells survival after 72 hours exposure to mitomycin.
  • FIG. 35 is a scatter plot depicting % NCI-2052H cells survival after 72 hours exposure to doxorubicin.
  • FIG. 36 is a scatter plot depicting % NCI-2052H cells survival after exposure to talc or talc/doxorubicin.
  • FIG. 37 is a scatter plot depicting % NCI-2052H cells survival after 72 hours exposure to paclitaxel.
  • FIG. 38 is a scatter plot depicting % NCI-2052H cells survival after 72 hours exposure to talc or talc/paclitaxel.
  • FIG. 39 is the data and a bar graph showing the comparison of survival NCI-2052H cells with different treatments.
  • FIG. 40 is a scatter plot depicting % NCI-2052H cells survival after 72 hours exposure to talc or talc/mitomycin.
  • FIG. 41 is a scatter plot depicting % NCI-2052H cells survival after 72 hours exposure to mitomycin.
  • FIG. 42 is an illustration of the gelatin matrix comprising a gelfoam tile for treatment of bladder cancer.
  • FIG. 43 shows a flow chart of a method of infusing a radioisotope into a bladder according to an embodiment of the present disclosure.
  • FIG. 44 shows a result of a test column: BioSep-SEC-S-2000 (Sigma-Aldrich), eluent PBS pH 6.8, according to an embodiment of the present disclosure.
  • FIG. 45 shows a system for the administration of a radioisotope, according to an embodiment of the present disclosure.
  • FIG. 46 shows an intact urinary bladder of a pig.
  • FIG. 47 shows an incised urinary bladder of a pig.
  • FIG. 48 shows an underside view of a urinary bladder of a pig stretched over a 24-well styrene microplate.
  • FIG. 49 shows a further underside view of a urinary bladder of a pig stretched over a 24-well styrene microplate.
  • FIG. 50 shows eight nylon spacers forced into eight of the wells of FIG. 49.
  • FIG. 51 shows 24 nylon spacers forced into each of the wells of FIG. 49.
  • FIG. 52 shows another view of all 24 wells of FIG. 49 with nylon spacers.
  • FIG. 53 shows pressure maintained on the nylon spacers using nylon inserts affixed to an upper complementary microplate held with elastic bands.
  • FIG. 54 shows a bottom view of the microplate assembly with a single air hole per well and a filter paper floor.
  • FIG. 55 shows a top view of the microplate assembly of FIG. 54.
  • FIG. 56 shows a bottom view of the shape of the individual mucosal lined experimental mucosal wells of FIG. 54.
  • FIG. 57 shows a diagram of a microplate well.
  • FIG. 58 shows a drawing of an interior of a human bladder.
  • FIG. 59 shows a drawing of a vertical section of a human bladder wall.
  • radiotherapeutic agent-based targeted therapy can prolong the life of a subject with a neoplastic disorder, such as intracavitary cancer, or supplement or replace surgery or chemotherapy.
  • gelfoam can be functionalized with avidin and incubated with a biotinylated radioisotope and placed under direct vision on or near a pathological tissue site with a precisely pre-calculated radiation dose which is not currently possible with a liquid dose.
  • the application of the gelfoam constructs for the treatment of cancer can involve the isolation of the cancerous tissues from the urinary stream, and the introduction of radioactive formulations that would deliver cytocidal doses of alpha or beta particle radiation to a precise depth of penetration greater and more uniform than what can be accomplished with standard intravesical chemotherapy.
  • talc a type of mineral
  • silicate a silicate
  • a therapeutic agent can be injected into the pleural cavity of a subject after pleurodesis.
  • a therapeutic agent bound to a substrate can be used as a targeting agent.
  • the substrate e.g., talc
  • the therapeutic agent can be trapped in the potential pleural space formed. Accordingly, targeted therapy of a pleurodesed space can be performed (e.g., repeatedly performed) without compromising surrounding tissue, or without excessive systemic toxicity.
  • a therapeutic agent By linking a therapeutic agent to a molecule or substrate (e.g., talc itself or to molecules or particles that can be mixed with talc), the pleurodesed areas containing the therapeutic agent can be targeted to the areas with which they come in contact. It follows from the above that if therapeutic agent-conjugated molecules or particles (e.g., therapeutic agent-talc) can be deposited in a tissue in a controlled uniform manner, the dosage given to a subject can be precisely controlled at the site.
  • a molecule or substrate e.g., talc itself or to molecules or particles that can be mixed with talc
  • compositions and methods described herein can include the use of cytotoxic agents or chemotherapeutic agents bound to silica or talc, thus effectively killing cells in their vicinity but not significantly or substantially harming more distant tissues or bone marrow.
  • therapeutic agent-conjugated talc can be injected into the pleural space of a subject for precisely targeting therapy of mesothelioma or other cancers
  • the present disclosure is based, at least in part, on the discovery that a combination of a ligand coupled to (an endogenous or exogenous) molecule or substrate and a receptor coupled to a radioisotope (or vice versa, a receptor coupled to molecule or substrate and a ligand coupled to a radioisotope) can be used to precisely deliver targeted radiotherapy to a tissue of a subject in need thereof.
  • a combination of a ligand coupled to (an endogenous or exogenous) molecule or substrate and a receptor coupled to a radioisotope can be used to precisely deliver targeted radiotherapy to a tissue of a subject in need thereof.
  • Such an approach can provide a ligand-based pre-target for a subsequent administration of receptor-radioisotope complex.
  • Such an approach can be amenable to a broad array of natural and artificial materials including, but not limited to, polylactic materials, glass, or other surgical, prosthetic, implantable materials, or endogenous tissues.
  • radioisotopes can be selectively targeted to a tumor-contaminated pleural space given the presence of the avidin or streptavidin target.
  • a ligand e.g., avidin or streptavidin bound to substrate (e.g., talc) can be used as a pretargeting agent.
  • the substrate e.g., talc
  • the ligand e.g., avidin or streptavidin
  • the ligand-coupled radioisotopes e.g., biotinylated radioisotopes
  • targeted radiotherapy of a pleurodesed space can be performed (e.g., repeatedly performed) without compromising surrounding tissue, or without excessive systemic toxicity.
  • a ligand e.g., avidin or related molecules
  • a molecule or substrate e.g., talc itself or to molecules or particles that can be mixed with talc
  • the pleurodesed areas containing the ligand can be positioned to bind tightly to any circulating receptor-containing small molecules (e.g., biotin-radioisotope) with which they come in contact, with an circulating receptor-containing small molecules (e.g., biotin-radioisotope) with which they come in contact, with an circulating receptor-containing small molecules (e.g., biotin-radioisotope) with which they come in contact, with an circulating receptor-containing small molecules (e.g., biotin-radioisotope) with which they come in contact, with an circulating receptor-containing small molecules (e.g., biotin-radioisotope) with which they come in contact, with an circulating receptor-containing small molecules (e.g., biotin-
  • biodegradable ligand-conjugated molecules or particles e.g., avidin-talc
  • they can precisely determine the shape and intensity of radiotherapy delivered by alpha-emitting receptor-conjugated radioisotopes (e.g., biotin- radioisotope) attracted to the site.
  • Various systems described herein can include the use of receptor-conjugated alpha emitting isotopes, for example Radium 223 or Bismuth 212, which emit energetic alpha particles over a short range (e.g., about 1 10 microns or less), thus effectively killing cells in their vicinity but not significantly or substantially harming more distant tissues or bone marrow.
  • an isotope can be safely given repeatedly as often as weekly or monthly with no rise in side effects attributable to the drug.
  • avidin- or streptavidin-conjugated silica or talc can be injected into the pleural space of a subject to attract biotin-labeled alpha emitting isotopes (e.g., Radium 223, Bismuth 212, Yttrium 90) for precisely targeted radiotherapy of mesothelioma or other cancers occupying the pleural space needing such treatment.
  • biotin-labeled alpha emitting isotopes e.g., Radium 223, Bismuth 212, Yttrium 90
  • a ligand e.g., avidin or streptavidin
  • a ligand-fibrinogen complex can then be incorporated into a fibrin "glue", or a fibrin mesh or gel, and activated with thrombin.
  • the ligand-fibrin glue, mesh, or gel can be used as a support, sealant, clot-promoting agent, or surgical adhesive.
  • a receptor-radioisotope e.g., a biotinylated alpha emitting radioisotope
  • a ligand e.g., avidin or streptavidin
  • gelatin such as can be present in a conventional surgical gelfoam (e.g., in the form of a pad, powder, or gauze).
  • the stability of the ligand-gelfoam complex may be incrementally enhanced and adjusted by crosslinking the proteins by exposing the mixture to ultraviolet light.
  • the gelfoam can then be used as is, or optionally incorporated into a fibrin "glue", or a fibrin mesh or gel, and activated with thrombin.
  • the avidin-gelfoam material can itself serve as a support, sealant, clot-promoting agent, or surgical adhesive.
  • a receptor-radioisotope e.g., a biotinylated alpha emitting radioisotope
  • compositions, systems, or methods in which the ligand is not coupled to a molecule or substrate prior to administration to a subject in which the ligand is not coupled to a molecule or substrate prior to administration to a subject.
  • a "bare" ligand has specific or non-specific binding affinity for a biological tissue associated with a disease, disorder, or condition described herein.
  • a ligand such as avidin having a highly positive charge can adhere to a negatively charged tissue, such as a peritoneal surface.
  • Avidin administered to at or near the peritoneal membrane e.g., by injection, where it binds.
  • a receptor-radioisotope complex e.g., a biotinylated radioisotope
  • a receptor-radioisotope complex can be directly introduced into the cavity (e.g., by radiologically guided catheter), where it would bind to avidin (or other ligand) on exposed surfaces.
  • Intravenous avidin could simultaneously "clear" some or all isotope escaping from the peritoneal cavity.
  • a molecule or substrate, or plurality or combination thereof can be coupled to a therapeutic agent (e.g., chemotherapeutic agent) so as to provide a therapeutic effect (e.g., a cytotoxic effect) in an area in or around the molecule or substrate.
  • a molecule or substrate, or plurality or combination thereof can be coupled to a ligand (e.g., avidin, streptavidin) so as to attract a radioisotope coupled to a corresponding receptor (e.g., biotin).
  • a ligand e.g., avidin, streptavidin
  • a molecule can be a plurality of molecules.
  • a substrate can be a plurality of substrates.
  • a molecule can be a molecule endogenous or exogenous to the subject.
  • a molecule as described herein can be a microsphere or other particle.
  • a molecule as described herein can be a microsphere or other particle introduced into talc.
  • a molecule or a plurality of molecules coupled or attached to part of a ligand/receptor pair can be any molecule present in or introduced into a subject having a proliferative disease, disorder, or condition.
  • a substrate can be any natural or artificial material.
  • Exemplary substrates include, but are not limited to, talc, fibrin, polymeric materials, plastics, plastic fillers, latex particles, gels, polylactic materials, microspheres, glass, proteinaceous materials, carbohydrate materials, or other surgical, prosthetic, or implantable materials, such as a mesh, suture, tissue scaffold, or other such materials.
  • a molecule or substrate can be an endogenous tissue of the subject (e.g., a peritoneal membrane).
  • a molecule or a plurality of molecules coupled or attached to part of a ligand/receptor pair or a therapeutic agent can be, for example, silica, silicate, or talc.
  • Talc is understood to be a metamorphic mineral composed of hydrated magnesium silicate with the chemical formula H 2 Mg3(Si0 3 ) 4 or Mg 3 Si 4 Oio(OH) 2 .
  • Talc is understood to have a tri-octahedral layered structure, similar to that of pyrophyllite, but with magnesium in the octahedral sites of the composite layers.
  • talc can mean a hydrated magnesium silicate (e.g., H 2 Mg 3 (Si03) 4 or Mg 3 Si 4 Oio(OH) 2 ), a variant thereof, or a similar silicate.
  • a molecule or a plurality of molecules coupled or attached to part of a ligand/receptor pair or a therapeutic agent can be a soft mineral similar to talc, such as steatite, pinite, pyrophyllite (a.k.a. French chalk).
  • a molecule or a plurality of molecules coupled or attached to part of a ligand/receptor pair or a therapeutic agent can be a talc-schist, such as steatite.
  • Talc and asbestos are both naturally occurring silicate minerals. Asbestos is
  • silicate minerals that share an eponymous asbestiform habit of long, thin crystals (e.g., serpentine, chrysotile, amphibole, amosite, crocidolite, tremolite, actinolite, anthophyllite, richterite, winchite).
  • Surface features and binding characteristics of asbestos can be useful for characterizing binding of talc, or another silicate, to one part of a ligand/receptor pair (e.g., avidin or streptavidin) or a therapeutic agent (e.g.,
  • talc has a high capacity to absorb and accommodate biomolecules (e.g., a ligand or a receptor) on its surface area. Accordingly, talc or other silicates should have a high capacity for linkage to a ligand or a receptor or a therapeutic agent, as described herein. Such predictive mechanism has been confirmed by preliminary talc-avidin and talc-chemotherapeutic agent binding studies.
  • a molecule or substrate can be fibrin.
  • Fibrin is generally understood as a fibrous, non-globular protein involved in the clotting of blood, which can be formed by the action of protease thrombin on fibrinogen (a glycoprotein), which causes the latter to polymerize.
  • Fibrin sealant has been used with increasing frequency in a variety of surgical field for its unique hemostatic and adhesive abilities, such as mimicking the last step of the coagulation cascade independently of a subjects coagulation status (see generally, Lee, 2005, Surg Innov, 12(3), 203-213; Gibble and Ness, 1990, Transfusion, 30(8), 741 -747;
  • fibrin or fibrinogen can be coupled to a therapeutic agent.
  • fibrin or fibrinogen can be coupled to avidin.
  • Fibrinogen can be dispensed as a "glue", where after being applied, it can be treated with thrombin (so as to polymerize and form fibrin) to produce a biotinylated clot.
  • a subject can be given intravenous avidin to displace any unbound biotin, and some time later (e.g., about 24 hours later), a biotinylated radioisotope can be given, which would then bind to the avidin immobilized on the fibrinogen clot.
  • fibrin or fibrinogen can be biotinylated.
  • a protein such as fibrinogen e.g., about 10 to about 20 mg/ml
  • the biotinylated fibrinogen can then be dispensed as a "glue", where after being applied, it can be treated with thrombin (so as to polymerize and form fibrin) to produce a biotinylated clot.
  • thrombin ser as to polymerize and form fibrin
  • the subject can be given intravenous avidin which would be expected to bind to the biotinylated fibrinogen.
  • Unbound avidin can be expected to be cleared after some amount of time (e.g., about 2 hours, about 3 hours, or up to 24 hours).
  • a molecule e.g., talc
  • a ligand e.g., avidin
  • a therapeutic agent e.g., a chemotherapeutic agent
  • a fibrin/gelatin matrix e.g., an FDA-approved fibrin/gelatin matrix
  • a substrate can be a gelatin matrix.
  • a gelatin matrix can comprise a gelatin, a gelfoam, a gelfoam pad, a gelfoam strip, a gelfoam mesh, a gelfoam paste, a gelfoam tile, or a combination thereof.
  • a gelfoam tile can be a gelfoam composition that can be cut or formed into "tiles" such as a gelfoam, a gelfoam pad, a gelfoam strip, or a gelfoam mesh.
  • a composition comprising gelfoam can be a gelfoam tile.
  • the gelfoam tile can be about 0.5 to about 2 mm thick (in width).
  • the thickness of the gelfoam tile can be about 0.5 mm, about 0.6 mm, about 0.7 mm, about 0.8 mm, about 0.9 mm, about 1 .0 mm, about 1.1 mm, about 1 .2 mm, about 1 .3 mm, about 1 .4 mm, about 1 .5 mm, about 1 .6 mm, about 1.7 mm, about 1 .8 mm, about 1 .9 mm, about 2.0 mm, about 2.1 mm, about 2.2 mm, about 2.3 mm, about 2.4 mm, about 2.5 mm, about 2.6 mm, about 2.7 mm, about
  • the gelfoam tiles can be about 1 -4 cm x 1 -4 cm (length x height) in shape.
  • the height or length of the gelfoam tile can be about 0.5 cm, about 0.6 cm, about 0.7 cm, about 0.8 cm, about 0.9 cm, about 1 .0 cm, about 1 .1 cm, about 1 .2 cm, about 1 .3 cm, about 1 .4 cm, about 1 .5 cm, about 1 .6 cm, about 1 .7 cm, about 1 .8 cm, about
  • the tiles can be stacked or layered to increase the width (e.g., with or without radioisotopes to, for example, modulate radioactive dose and/or control depth of penetration or radial extension of the radioactive dose).
  • the gelfoam tile can be offset from the target site by a distance of about 0.1 mm, about 0.2 mm, about 0.3 mm, about 0.4 mm, about 0.5 mm, about 0.6 mm, about 0.7 mm, about 0.8 mm, about 0.9 mm, about 1 .0 mm, about 1.1 mm, about 1 .2 mm, about 1.3 mm, about 1 .4 mm, about 1 .5 mm, about 1 .6 mm, about 1.7 mm, about 1 .8 mm, about 1.9 mm, about 2.0 mm, about 2.1 mm, about 2.2 mm, about 2.3 mm, about 2.4 mm, about 2.5 mm, about 2.6 mm, about 2.7 mm, about
  • the gelfoam tiles can be tiled to cover a larger area or can be cut into irregular shape to accommodate the size treatment area.
  • the tiles can be impregnated with radiopaque material.
  • the gelatin matrix can be covered with any material suitable to form a clot over the gelatin matrix.
  • a molecule or a plurality of molecules coupled or attached to part of a ligand/receptor pair can be, for example, a gelatin. It has been discovered that positively charged avidin can form multiple linkages with a gelatin matrix, such as that used in a gelfoam. UV light or radiation can be used to initiate the gelatin avidin bond. A gelatin matrix can be exposed to UV radiation for an amount of time sufficient to form the avidin gelatin bond. The time sufficient to form a bond between avidin and gelatin can be about 10 minutes to two hours. For example, the time sufficient to form a bond between avidin and gelatin can be about 10 minutes, about 20 minutes, about 30 minutes, about 40 minutes, about
  • a gelfoam can be understood to be a particulate embolic agent that can temporarily occlude blood vessels for a period of time (e.g., up to five weeks) by absorbing liquid and plugging the vessel.
  • a gelfoam can be a frequently used surgical hemostatic device.
  • a gelfoam can attach or adhere to tissue or can be attached to tissue with adhesive.
  • a gelfoam can be composed of water-insoluble gelatin particles that may travel distally and occlude smaller capillaries.
  • a ligand described herein, such as avidin, can be mixed with gelatin particles so as to form a gelfoam of gelatin bound to ligand (e.g., gelatin-avidin complex).
  • Gelfoam can be a purified gelatin sponge.
  • Gelfoam can be biodegradable.
  • Gelfoam can be commercially available (e.g.,
  • Gelfoam® Pfizer/Baxter
  • Conventional use of gelfoam is understood in the art. Except as otherwise noted herein, therefore, methods and compositions of the present disclosure (e.g., ligand-gelatin complex in a gelfoam) can be carried out in accordance with such processes.
  • gelatin can be coupled to a ligand (e.g., avidin or streptavidin).
  • a ligand e.g., avidin or streptavidin
  • the gelatin can be present in a conventional surgical gelfoam (e.g., in the form of a powder or gauze).
  • the gelfoam can then be used as is, or optionally incorporated into a fibrin "glue", or a fibrin mesh or gel, and activated with thrombin.
  • the avidin-gelfoam material can itself serve as a support, sealant, clot-promoting agent, or surgical adhesive.
  • a receptor-radioisotope e.g., a biotinylated alpha emitting
  • the ligand-molecule or substrate complex can be exposed to ultraviolet light for a period of time sufficient to stabilize or strength the coupling there between.
  • the stability of the ligand-gelfoam complex may be incrementally enhanced and adjusted by crosslinking the proteins by exposing the mixture to ultraviolet light.
  • gelfoam loaded with avidin may lose some of the attached material when exposed to serum. This may be a problem if the loaded gauze is placed in juxtaposition with tissues for long periods. It has further been discovered that exposing gelfoam (e.g., gauze or pellets) to ultraviolet light for varying periods of time can stabilize the bond between gelfoam and avidin while retaining an ability to bind biotin.
  • gelfoam e.g., gauze or pellets
  • no reagents are needed other than gelfoam and avidin.
  • a therapeutic agent can be coupled to a substrate.
  • a substrate can be a silicate, talc, fibrin, gelatin, or gelfoam.
  • a substrate can include an implantable devices, for example: drug-delivering vascular stents (e.g., self -expanding stents typically made from nitinol, balloon-expanded stents typically prepared from stainless steel, cobalt chrome, and others); other vascular devices (e.g., grafts, catheters, valves, artificial hearts, heart assist devices); implantable defibrillators, especially defibrillator leads; blood oxygenator devices (e.g.
  • tubing tubing, membranes
  • surgical devices e.g. , sutures, staples, anastomosis devices, vertebral disks, bone pins, suture anchors, hemostatic barriers, clamps, screws, plates, clips, vascular implants, tissue adhesives and sealants, tissue scaffolds
  • membranes cell culture devices; chromatographic support materials; biosensors; shunts for hydrocephalus; wound
  • endoscopic devices e.g. , for joint implants, fracture repairs
  • dental devices e.g. , dental implants, fracture repair devices
  • urological devices e.g. , penile, sphincter, urethral, bladder, prostrate, vaginal, fallopian, and renal devices, and catheters
  • colostomy bag attachment devices e.g., ophthalmic devices ⁇ e.g., ocular coils); glaucoma drain shunts; synthetic prostheses (e.g. , breast);
  • intraocular lenses respiratory, peripheral, cardiovascular, spinal, neurological, dental, gastrointestinal, gastro-esophageal (e.g. , for Barrett's Esophagus or pre-cancerous esophageal tissue or cells), ear/nose/throat (e.g. , ear drainage tubes) devices; renal devices; iliac devices; cardiac devices; aortic devices ⁇ e.g., grafts or stents); and dialysis devices (e.g. , tubing, membranes, grafts).
  • gastro-esophageal e.g. , for Barrett's Esophagus or pre-cancerous esophageal tissue or cells
  • ear/nose/throat e.g. , ear drainage tubes
  • renal devices e.g., iliac devices
  • cardiac devices e.g., grafts or stents
  • dialysis devices e.g. , tubing, membranes, grafts
  • pacer leads glucose sensors (long-term and short- term), degradable, non-degradable, or partially degradable coronary stents, blood pressure and stent graft catheters, birth control devices, benign prostate and prostate cancer implants, bone repair/augmentation devices, breast implants, cartilage repair devices, dental implants, implanted drug infusion tubes, intravitreal drug delivery devices, nerve regeneration conduits, oncological implants, electrostimulation leads, pain management implants, spinal/orthopedic repair devices, wound dressings, embolic protection filters, abdominal aortic aneurysm grafts, heart valves (e.g.
  • valve annuloplasty devices mitral valve repair devices
  • vascular intervention devices left ventricle assist devices
  • neuro aneurysm treatment coils neurological catheters
  • left atrial appendage filters hemodialysis devices
  • catheter cuff anastomotic closures
  • vascular access catheters cardiac sensors, uterine bleeding patches, uterine stent or stent-like devices, cervix treatment devices, urological catheters/stents/im plants, gastro-esophageal stents, treatments for lower esophageal sphincter, in vitro diagnostics, aneurysm exclusion devices, and neuropatches.
  • Non-limiting examples of substrates include vena cava filters, urinary dilators, endoscopic surgical tissue extractors, endoscopic drug or fluid delivery devices, atherectomy catheters or devices, imaging catheters or devices (e.g., Intravascular Ultrasound (IVUS), Magnetic Resonance Imaging (MRI), or Optical Coherence Tomography (OCT) catheters or devices), thrombis or clot extraction catheters or devices (e.g., thrombectomy devices), percutaneous transluminal angioplasty catheters or devices, PTCA catheters, stylets
  • IVUS Intravascular Ultrasound
  • MRI Magnetic Resonance Imaging
  • OCT Optical Coherence Tomography
  • thrombis or clot extraction catheters or devices e.g., thrombectomy devices
  • percutaneous transluminal angioplasty catheters or devices PTCA catheters, stylets
  • vascular and non-vascular guiding catheters, drug infusion catheters, esophageal stents, pulmonary stents, bronchial stents, circulatory support systems, angiographic catheters, transition sheaths and dilators, coronary and peripheral guidewires, hemodialysis catheters, neurovascular balloon catheters or devices, tympanostomy vent tubes, cerebro-spinal fluid shunts, defibrillator leads, percutaneous closure devices, drainage tubes, thoracic cavity suction drainage catheters, electrophysiology catheters or devices, stroke therapy catheters or devices, abscess drainage catheters, biliary drainage products, dialysis catheters, central venous access catheters, and parental feeding catheters or devices.
  • Non-limiting examples of substrates include catheters, implantable vascular access ports, blood storage bags, vascular stents, blood tubing, arterial catheters, vascular grafts, intraaortic balloon pumps, sutures (e.g., cardiovascular), total artificial hearts and ventricular assist pumps, extracorporeal devices such as blood oxygenators, blood filters, hemodialysis units, hemoperfusion units, plasmapheresis units, hybrid artificial organs such as pancreas or liver and artificial lungs, as well as filters adapted for deployment in a blood vessel in order to trap emboli (also known as “distal protection devices” or “distal embolic protection devices”).
  • emboli also known as "distal protection devices” or “distal embolic protection devices”
  • postoperative therapy e.g., chemotherapy
  • risk of injury e.g., radiation or cellular toxicity
  • other areas of the tissue or organ e.g., liver or kidney
  • a ligand or a therapeutic agent can be coupled to a fibrin sealant sprayed on a synthetic bioabsorbable sheet made of mixture of polyabsorable material such as a mixture of polygycolic and acid and polylactic acid (e.g., Resomer®, GMP).
  • a ligand can be coupled to a PGA fabric, nonwoven homopolymer (e.g., Neovell, Gunze, Kyoto Japan) that hydrolozyes and disintegrates by about 50% in about 10 days, with remaining product disintegrating in about 15 weeks.
  • a ligand or a therapeutic agent can be coupled to a transparent fibrin glue film dressing that can be sprayed onto a surface.
  • a ligand or a therapeutic agent can be coupled to an aerosolized fibrin sealant (Bolheal, Chemo-Sero-Therapeutic Research Institute,
  • a ligand or a therapeutic agent can be coupled to a bioengineered human collagen dermal fillers (e.g., CosmoDerm I, CosmoDem II, CosmoPlast), which contain collagen fillers and lidocaine.
  • a ligand or a therapeutic agent can be coupled to a Bovine collagen (e.g., Zyderm I, Zyderm II, and Zyplast).
  • a ligand can be coupled to sheets of collagen coated with fibrinogen, thrombin, or aprotinin (e.g., TachoComb®, Nycomed Pharma; TachoSil®, Takeda Pharmaceuticals).
  • a molecule or substrate can be composed of any suitable biocompatible, bioerodable, or bio-tolerant material including, but not limited to, gold, tantalum, iridium, platinum, nitinol, stainless steel, platinum, titanium, tantalum, nickel-titanium, cobalt-chromium, magnesium, ferromagnetic, nonferromagnetic, alloys thereof, fiber, cellulose, various biodegradable or non-biodegradable polymers, or combinations thereof.
  • a substrate can be composed of MP35N or MP20N (trade names for alloys of cobalt, nickel, chromium, and molybdenum, Standard Press Steel Co., PA).
  • a molecule or substrate can be composed of a biodegradable, a bioerodable, a non- biodegradable material, a non-bioerodable material, or a combination thereof.
  • a molecule or substrate can be permanent or temporary.
  • a temporary molecule or substrate can be resident for a period of time such as about one day, about 10 days, about 15 days, about 30 days, about 60 days, about 90 days, or longer.
  • a molecule or substrate can be composed, in whole or in part, of a non-biodegradable polymer such as polyetheretherketone (PEEK), PEEK derivatives, polyethyleneteraphthalate, polyetherimide, polymide, polyethylene, polyvinylfluoride, polyphenylene,
  • PEEK polyetheretherketone
  • polytetrafluroethylene-co-hexafluoropropylene polymethylmethacrylate, polyetherketone, poly (ethylene-co-hexafluoropropylene), polyphenylenesulfide, polycarbonate, poly
  • a molecule or substrate can be composed, in whole or in part, of a biodegradable materials, such as polycaprolactone, poly (D,-lactide), polyhydroxyvalerate, polyanhydrides, polyhydroxybutyrate, polyorthoesters, polyglycolide, poly (L-lactide), copolymers of lactide and glycolide, polyphosphazenes, or polytrimethylenecarbonate.
  • a biodegradable materials such as polycaprolactone, poly (D,-lactide), polyhydroxyvalerate, polyanhydrides, polyhydroxybutyrate, polyorthoesters, polyglycolide, poly (L-lactide), copolymers of lactide and glycolide, polyphosphazenes, or polytrimethylenecarbonate.
  • a therapeutic agent e.g., a chemotherapeutic agent or
  • radiotherapeutic agent can be coupled to a molecule or substrate. Such an approach can provide targeted therapy in a subject via binding of the therapeutic agent and molecule or substrate.
  • a therapeutic agent can be any agent or drug that treats any disease, disorder, or condition.
  • a therapeutic agent can be a cytotoxic therapeutic agent or a radioactive
  • a therapeutic agent can be a chemotherapeutic agent.
  • a chemotherapeutic agent can be one or more anti-cancer drugs that are given as part of a standardized chemotherapy regimen.
  • a chemotherapeutic agent can be given with a curative intent, or it may aim to prolong life or to reduce symptoms (palliative chemotherapy).
  • a chemotherapeutic agent can be given with other therapeutic agents.
  • a therapeutic agent can include hormonal therapeutic agents or targeted therapeutic agents.
  • Therapeutic agents can be used in conjunction with other treatments (e.g., cancer treatments), such as radiation therapy, surgery, or hyperthermia therapy.
  • chemotherapeutic agents can also be used to treat other conditions, including AL amyloidosis, ankylosing spondylitis, multiple sclerosis, Crohn's disease, psoriasis, psoriatic arthritis, systemic lupus erythematosus, rheumatoid arthritis, and scleroderma.
  • Chemotherapeutic agents can be cytotoxic. Cytotoxic agents can kill cells that divide rapidly, one property of most cancer cells. Chemotherapeutic agents can also harm cells that divide rapidly under normal circumstances: cells in the bone marrow, digestive tract, or hair follicles. This can result in the common side-effects of chemotherapy: myelosuppression (decreased production of blood cells, hence also immunosuppression), mucositis
  • Chemotherapeutic agents may also not be indiscriminately cytotoxic, but can target proteins that are abnormally expressed in cancer cells and are essential for their growth. Such chemotherapeutic agents can be referred to as targeted therapeutic agents (to distinguish from conventional chemotherapeutic agents) and can be used alongside traditional chemotherapeutic agents in antineoplastic treatment regimens.
  • Chemotherapeutic agents can be one drug (single-agent chemotherapy) or several drugs at once (e.g., combination chemotherapy or polychemotherapy). For example, the combination of chemotherapy and radiotherapy can be referred to as chemoradiotherapy. Chemotherapeutic agents using drugs that convert to cytotoxic activity only upon light exposure is called photochemotherapy or photodynamic therapy.
  • a composition described herein can include a molecule or substrate coupled to two or more therapeutic agents.
  • Targeted therapeutic agents can overcome many issues seen with the use of cytotoxic agents.
  • Targeted therapeutic agents can be localized or directed to a specific area or site of pathology.
  • Targeted therapeutic agents can be small molecules or antibodies.
  • the toxicity seen with the use of cytotoxics can be due to the lack of cell specificity of the drugs.
  • Cytotoxic agents can kill a rapidly dividing cell, tumor cell, or normal cell.
  • Targeted therapeutic agents can be designed to affect cellular proteins or processes that can be utilized by cancer cells.
  • Targeted therapeutic agents can allow for a high dose to cancer tissues with a relatively low dose to other tissues.
  • Targeted therapeutic agents can be used on a cancer-specific or patient-specific basis. Side effects can be often less severe than that of traditional methods of administering cytotoxic chemotherapeutic agents.
  • Targeted therapeutics can be selective for one protein.
  • Targeted therapeutics can bind a range of protein targets.
  • Targeted therapeutic agents can target the protein produced by the Philadelphia chromosome, a genetic lesion found commonly in chronic myelomonocytic leukemia. This fusion protein has enzyme activity that can be inhibited by imatinib, a small molecule drug.
  • Chemotherapeutic agents can be used in diseases other than cancer (e.g., cancer, cardiovascular disease, diabetes, neurological disorders, neurological disorders, and cancer.
  • Chemotherapeutic agents can be often used at lower doses, which can mean that the side effects are reduced or minimized.
  • Chemotherapeutic agents such as methotrexate, can be used in the treatment of rheumatoid arthritis (RA), psoriasis, ankylosing spondylitis, or multiple sclerosis.
  • RA rheumatoid arthritis
  • psoriasis psoriasis
  • ankylosing spondylitis or multiple sclerosis.
  • the anti-inflammatory response seen in RA is presently thought to be due to increases in adenosine, which can cause immunosuppression, effects on immuno-regulatory cyclooxygenase-2 enzyme pathways, reduction in pro-inflammatory cytokines, or anti-proliferative properties.
  • Chemotherapeutic agents such as cyclophosphamide can be used to treat lupus nephritis, a common symptom of systemic lupus erythematosus.
  • Chemotherapeutic agents such as dexamethasone, bortezomib, or melphalan (or combinations thereof) is commonly used as a treatment for AL amyloidosis.
  • Chemotherapeutic agents such as bortezomid in combination with cyclophosphamide and dexamethasone can also treat AL amyloidosis.
  • Chemotherapeutic agents such as lenalidomide can treat myeloma and AL amyloidosis.
  • a chemotherapeutic agent can be used in conditioning regimens prior to bone marrow transplant (e.g., hematopoietic stem cell transplant).
  • Chemotherapeutic agents used in conditioning regimens can be used to suppress the recipient's immune system in order to allow a transplant to engraft.
  • Chemotherapeutic agents such as cyclophosphamide is a common cytotoxic drug used in this manner, and can be used in conjunction with total body irradiation.
  • Chemotherapeutic agents can be used at high doses to permanently remove the recipient's bone marrow cells (e.g., myeloablative conditioning) or at lower doses that will prevent permanent bone marrow loss (non-myeloablative and reduced intensity conditioning).
  • compositions described herein e.g., a molecule or substrate coupled to a therapeutic agent.
  • a therapeutic agent can be an antitumor antibiotic, anthracycline, platin, aziridine- containing composition, nucleoside analog, taxane, or diterpene.
  • a therapeutic agent can be a form of an antitumor antibiotic or anthracycline (e.g., bleomycin, bleomycin A2, bleomycin B2, actinomycin, plicamycin, mitomycin, Doxorubicin, daunorubicin, pirarubicin, aclarubicin, mitoxantrone, doxorubicin, myocet, adriamycin, Adriamycin PFS, Adriamycin RDF, rubex, doxil, caelyx,
  • an antitumor antibiotic or anthracycline e.g., bleomycin, bleomycin A2, bleomycin B2, actinomycin, plicamycin, mitomycin, Doxorubicin, daunorubicin, pirarubicin, aclarubicin, mitoxantrone, doxorubicin, myocet, adriamycin, Adriamycin PFS, Adriamycin R
  • Antitumor antibiotics or anthracyclines can be cytotoxic.
  • a therapeutic agent can be a form of a platin, a platinum-based antineoplastic (e.g., carboplatin, Paraplatin, Paraplatin-AQ, cisplatin, oxaliplatin, satraplatin, picoplatin, Nedaplatin, Triplatin, Lipoplatin).
  • Platinum-based antineoplastic agents can cause crosslinking of DNA as monoadduct, interstrand crosslinks, intrastrand crosslinks, or DNA protein crosslinks.
  • Platins can be cytotoxic.
  • a therapeutic agent can be a form of a nucleoside analog (e.g., analogue of pyrimidines, gemcitabine, cytarabine, fluorouracil, Adrucil, Carac, Efudex, Efudix, 5-FU, pyrimidine, floxuridine).
  • Nucleotide analogues can replace a building blocks of nucleic acids (e.g. in this case of flurouracil, it replaces cytidine), during DNA replication, which can arrest tumor growth, as only one additional nucleoside can be attached to the "faulty" nucleoside, resulting in apoptosis.
  • a nucleoside analog can be cytotoxic.
  • a therapeutic agent can be a form of aziridine-containing composition (e.g., mitomycin, mitomycin C, tamoxifen azidirine).
  • Aziridine-containing composition can be a potent DNA cross-linker and can cause DNA replication arrest and cell death.
  • a therapeutic agent can be a form of taxane or diterpenes (e.g., paclitaxel, docetaxel, cabazitaxel, theotepa, AZQ, BZQ). Taxanes or diterpenes can disrupt of microtubule function, inhibiting the process of cell division. Taxanes or diterpenes can be cytotoxic.
  • Ambochlorin Chlorambucil
  • Amboclorin Chlorambucil
  • Aminolevulinic Acid Anastrozole; Aprepitant; Aredia (Pamidronate Disodium); Arimidex (Anastrozole); Aromasin (Exemestane); Arranon (Nelarabine); Arsenic Trioxide; Arzerra (Ofatumumab); Asparaginase Erwinia chrysanthemi; Avastin (Bevacizumab); Axitinib; Azacitidine; BEACOPP; Becenum
  • Bevacizumab Bexarotene; Bexxar (Tositumomab and I 131 Iodine Tositumomab);
  • Bicalutamide; BiCNU Carmustine; Bleomycin; Blinatumomab; Blincyto (Blinatumomab); Bortezomib; Bosulif (Bosutinib); Bosutinib; Brentuximab Vedotin; Busulfan; Busulfex
  • Clofarabine Clolar (Clofarabine); CMF; Cometriq (Cabozantinib-S-Malate); COPP; COPP- ABV; Cosmegen (Dactinomycin); Crizotinib; CVP; Cyclophosphamide; Cyfos (Ifosfamide); Cyramza (Ramucirumab); Cytarabine; Cytarabine, Liposomal; Cytosar-U (Cytarabine);
  • Cytoxan (Cyclophosphamide); Dabrafenib; dacarbazine; Dacogen (Decitabine);
  • Dactinomycin Dactinomycin; Dasatinib; Daunorubicin Hydrochloride; Decitabine; Degarelix; Denileukin Diftitox; Denosumab; DepoCyt (Liposomal Cytarabine); DepoFoam (Liposomal Cytarabine); Dexrazoxane Hydrochloride; Dinutuximab; Docetaxel; Doxil (Doxorubicin Hydrochloride Liposome); Doxorubicin Hydrochloride; Doxorubicin Hydrochloride Liposome; Dox-SL
  • Doxorubicin Hydrochloride Liposome DTIC-Dome (Dacarbazine); Efudex (Fluorouracil); Elitek (Rasburicase); Ellence (Epirubicin Hydrochloride); Eloxatin (Oxaliplatin); Eltrombopag Olamine; Emend (Aprepitant); Enzalutamide; Epirubicin Hydrochloride; EPOCH; Erbitux (Cetuximab); Eribulin Mesylate; Erivedge (Vismodegib); Erlotinib Hydrochloride; Erwinaze (Asparaginase Erwinia chrysanthemi); Etopophos (Etoposide Phosphate); Etoposide;
  • Etoposide Phosphate Evacet (Doxorubicin Hydrochloride Liposome); Everolimus; Evista (Raloxifene Hydrochloride); Exemestane; Fareston (Toremifene); Farydak (Panobinostat); Faslodex (Fulvestrant); FEC; Femara (Letrozole); Filgrastim; Fludara (Fludarabine
  • Linfolizin Chlorambucil
  • LipoDox Doxorubicin Hydrochloride Liposome
  • Liposomal Cytarabine Lomustine
  • Lupron Leuprolide Acetate
  • Lupron Depot Leuprolide Acetate
  • Lupron Depot-Ped (Leuprolide Acetate); Lupron Depot-3 Month (Leuprolide Acetate); Lupron Depot-4 Month (Leuprolide Acetate); Lynparza (Olaparib); Marqibo (Vincristine Sulfate Liposome); Matulane (Procarbazine Hydrochloride); Mechlorethamine Hydrochloride; Megace (Megestrol Acetate); Megestrol Acetate; Mekinist (Trametinib); Mercaptopurine; Mesna; Mesnex (Mesna); Methazolastone (Temozolomide); Methotrexate; Methotrexate LPF (Methotrexate); Mexate (Methotrexate); Mexate-AQ (Methotrexate); Mitomycin C;
  • Mitoxantrone Hydrochloride Mitozytrex (Mitomycin C); MOPP; Mozobil (Plerixafor);
  • Olaparib Omacetaxine Mepesuccinate; Oncaspar (Pegaspargase); Ontak (Denileukin Diftitox); Opdivo (Nivolumab); OPPA; Oxaliplatin; Paclitaxel; Paclitaxel Albumin-stabilized Nanoparticle Formulation; PAD; Palbociclib; Palifermin; Palonosetron Hydrochloride;
  • Temsirolimus Thalidomide; Thalomid (Thalidomide); Thiotepa; Toposar (Etoposide);
  • Topotecan Hydrochloride Toremifene; Torisel (Temsirolimus); Tositumomab and I 131 Iodine Tositumomab; Totect (Dexrazoxane Hydrochloride); TPF; Trametinib; Trastuzumab; Treanda (Bendamustine Hydrochloride); Trisenox (Arsenic Trioxide); Tykerb (Lapatinib Ditosylate); Unituxin (Dinutuximab); Vandetanib; VAMP; Vectibix (Panitumumab); VelP; Velban
  • VePesid Etoposide
  • Viadur Leuprolide Acetate
  • Vidaza Azacitidine
  • Vinblastine Sulfate Vincasar PFS (Vincristine Sulfate); Vincristine Sulfate; Vincristine Sulfate Liposome;
  • Vinorelbine Tartrate VIP; Vismodegib; Voraxaze (Glucarpidase); Vorinostat; Votrient
  • a therapeutic agent can be:
  • a ligand e.g., a streptavidin, an avidin
  • a ligand can be coupled to a molecule or substrate so as to attract a radioisotope coupled to a corresponding receptor.
  • a ligand can be selective or non-selective for a receptor.
  • a ligand can be preferably selective for a receptor (or vice versa, a receptor can be preferably selective for a ligand). Streptavidin.
  • a ligand can be a streptavidin.
  • a streptavidin can be a protein having a high affinity for biotin (e.g., K d of about 10 "14 mol/L).
  • a streptavidin or a nucleotide encoding such can be isolated from the bacterium Streptomyces (e.g., Streptomyces avidinii).
  • a streptavidin can be any commercially available streptavidin (e.g., Invitrogen; Qiagen; Thermo Scientific; Jackson ImmunoResearch; Sigma Aldrich; Cell Signaling Technology).
  • a streptavidin can be a variant of a naturally occurring streptavidin having at least about 80%, 85%, 90%, 95%, or 99% sequence identity thereto and retaining or substantially retaining high affinity for biotin.
  • a streptavidin can be a tetramer, with each subunit binding a biotin with equal or substantially equal affinity.
  • a streptavidin can have a mildly acidic isoelectric point (pi) (e.g., about 5).
  • pi isoelectric point
  • a streptavidin can lack any carbohydrate modification. Where a streptavidin has no carbohydrate modification and a near-neutral pi, it can have substantially lower nonspecific binding compared to avidin.
  • a streptavidin can be an streptavidin coupled to a glycan.
  • a streptavidin can be a glycol streptavidin (e.g., a, ethylene glycol streptavidin; or an streptavidin-poly (ethylene glycol)(PEG)).
  • a streptavidin be attached in a branched form
  • polyethylene glycol e.g., PEG- streptavidin
  • PEG- streptavidin PEG- streptavidin
  • a streptavidin can be a streptavidin variant.
  • a streptavidin can be a monovalent, divalent, and trivalent variant.
  • a variant streptavidin can have a near-neutral pi.
  • a ligand can be an avidin.
  • An avidin can be a protein having a high affinity for biotin (e.g., K d of about 10 "15 mol/L).
  • An avidin or a nucleotide encoding such can be isolated from egg white. Wild type avidin has about 30% sequence identity to wild type streptavidin, but highly similar secondary, tertiary and quaternary structure.
  • An avidin can be glycosylated, positively charged, or have pseudo-catalytic activity (i.e., enhance alkaline hydrolysis of an ester linkage between biotin and a nitrophenyl group) or can have a higher tendency for aggregation as compared to a streptavidin.
  • An avidin can be a tetramer of about 66-69 kDa in size.
  • An avidin can have about 10% of molecular weight attributed to carbohydrate content composed of about 4 to 5 mannose or about three N-acetylglucosamine residues.
  • an avidin can be a streptavidin variant.
  • an avidin can be a non- glycosylated avidin.
  • an avidin can be a deglycosylated avidin (e.g., Neutravidin), which can be more comparable to the size, pi or nonspecific binding of a wild type streptavidin.
  • an avidin can be a deglycosylated avidin having modified arginines, exhibiting a more neutral isoelectric point (pi) and can better overcome problems of non-specific binding.
  • Deglycosylated, neutral forms of avidin are commercially available (e.g., Extravidin, Sigma-Aldrich; Neutravidin, Thermo Scientific or Invitrogen;
  • an avidin can be an avidin coupled to a glycan.
  • an avidin can be a glycol avidin (e.g., a, ethylene glycol avidin; or an avidin- poly(ethylene glycol) (avidin-PEG)) (see generally, Caliceti et al., 2002, Journal of Controlled Release, 83, 97-108; Salmaso et al., 2005, Biochimica et Biophysica Acta, 1726, 57-66).
  • an avidin be attached in a branched form incorporating polyethylene glycol (e.g., PEG-avidin), which can give the avidin a branched structure, allowing it to bind more biotin.
  • An avidin can be a variant AvidinOXTM, which can be obtained by 4- hydroxyazobenzene-2'-carboxylic acid-assisted sodium periodate oxidation of avidin (see generally De Santis et al., 2010, Cancer Biother Radiopharm, 25(2), 143-148; U.S. Patent No. 8,562,947). This method can generate aldehyde groups from avidin carbohydrates, sparing biotin-binding sites from inactivation.
  • An avidin variant, such as AvidinOX can have an increased tissue half-life (e.g., one, two, or more weeks). In some embodiments, avidin can be pegylated to produce a much larger molecule
  • the pegylated molecule would be too large to pass easily out of the peritoneal cavity; and it could be introduced in a large volume of solution, and be allowed to attach to surfaces, then flushed out, and biotinylated isotopes (e.g., tracer biotinylated isotopes) could then be introduced, which would likewise coat the surfaces, and allowed to remain.
  • biotinylated isotopes e.g., tracer biotinylated isotopes
  • An avidin can have reversible binding characteristics through nitration or iodination of a binding site tyrosine, or exhibit strong biotin binding characteristics at about pH 4 or biotin release at a pH of about 10 or higher.
  • An avidin can be a monovalent, divalent, and trivalent variant of avidin.
  • a technique was developed for linking avidin, a 60,000 m.w. egg- white protein with a variety of substrates, including gelfoam.
  • An avidin-gelfoam bond can withstand repeated washing with human serum.
  • a ligand such as avidin can be incorporated into a matrix of gelatin bound to ligand so as to form an activated gelatin-avidin complex.
  • Avidin is known to bind to biotin, a small molecule (m.w. 244) that functions as a cofactor for transfer of CO2 groups to facilitate gluconeogenesis, fatty acid synthesis, and amino acid metabolism.
  • biotin can form a complex with avidin with one of the strongest non-covalent biological bonds known with a k of 10 "15 .
  • Methods for attaching biotin to other biologically active materials including radioactive isotopes are understood in the art.
  • avidin can be coupled to talc, for example, using both
  • talc can bind in excess of 2 nanograms of avidin per mg of talc (i.e., about 2 micrograms per gram). For context, about 2 grams of talc can be
  • a ligand can be a molecularly imprinted polymer (MIP).
  • MIP molecularly imprinted polymer
  • a MIP is understood as a synthetic compound that can select, recognize or capture biological substances. MIPs can be generated via the polymerization of monomers in the presence of a template (see generally, Alvarez-Lorenzo and Concheiro, Ed., 2013, Handbook of Molecularly Imprinted Polymers, Smithers Rapra Technology, ISBN-10: 1847359604).
  • a MIP can be processed using a molecular imprinting technique that leaves cavities in polymer matrix with affinity to a chosen "template” molecule.
  • the process can involve initiating polymerization of monomers in the presence of a template molecule that can be extracted afterwards, thus leaving complementary cavities behind.
  • Such polymers can have affinity for the original molecule and have been used in applications such as chemical separations, catalysis, or molecular sensors. Binding activity of MIPs, or so called “plastic antibodies”, can be about two orders of magnitude lower than specific antibodies but are still highly specific binding sites that can be made easily and are relatively inexpensive.
  • MIPs can be generated as specific for receptors described herein.
  • MIPs can be specific for biotin (see e.g., WO2014/030002).
  • MIPs can be coupled to a molecule or substrate described herein.
  • a radioisotope can be coupled to a receptor so as to provide targeted radiotherapy via selective binding to a molecule or substrate coupled to a ligand.
  • Systemic radioisotope therapy can be a form of targeted therapy.
  • targeting a radioisotope can be achieved by attaching it to one part of a ligand/receptor combination, where the other part can be attached to a target.
  • a radioisotope can be used to destroy or weaken cells associated with a proliferative disease, disorder, or condition.
  • a radioisotope that generates radiation can be localized in a desired location (e.g., a tissue) according to approaches described herein. In some
  • beta radiation from the radioisotope can result in the destruction of cells, which is a process understood as radionuclide therapy (RNT) or radiotherapy.
  • RNT radionuclide therapy
  • Short-range radiotherapy may be known as brachytherapy.
  • a radioisotope for use with compositions and methods described herein can be a strong beta emitter, optionally with sufficient gamma to enable imaging, such as lutetium-177.
  • Lutetium-177 can be prepared from ytterbium-176, which is irradiated to become Yb-177, which decays rapidly to Lu-177.
  • Lu-177 can emit sufficient beta radiation for therapy on small (e.g., endocrine) tumors.
  • Another exemplary radioisotope for use with compositions and methods described herein includes Yttrium-90, which can be conventionally used for treatment of cancer, particularly bladder cancer, cancers of intracavitary surfaces, non-Hodgkin's lymphoma and liver cancer, and as a silicate colloid for the relieving the pain of arthritis in larger synovial joints.
  • lodine-131 or phosphorus-32 examples include lodine-131 or phosphorus-32.
  • lodine-131 has been conventionally used to treat the thyroid for cancers and other abnormal conditions such as hyperthyroidism (i.e., over-active thyroid), lodine-131 is a strong gamma emitter, and can be conventionally used for beta therapy.
  • Phosphorus-32 has been conventionally used to treat Polycythemia vera, in which an excess of red blood cells is produced in the bone marrow and Phosphorus-32 can be used to control this excess.
  • Another exemplary radioisotope for use with compositions and methods described herein includes boron-10. A subject administered a composition including Boron-10 can be irradiated with neutrons which are strongly absorbed by the boron, to produce high-energy alpha particles that can kill cells including those associated with a proliferative disease, disorder, or condition.
  • Radioisotope for use with compositions and methods described herein includes Radium-223, which can be conventionally used for treatment of prostate cancer.
  • Another exemplary radioisotope for use with compositions and methods described herein includes bismuth-213.
  • Bismuth-213, having a 46-minute half-life and high energy (8.4 MeV), can be formed from readily available Actinium-225 (via 3 alpha decays).
  • Another exemplary radioisotope for use with compositions and methods described herein includes lead-212, having a half-life of 10.6 hours. Lead-212 has been conventionally attached to monoclonal antibodies for cancer treatment. Such approaches can be adapted for methods and compositions described herein.
  • the decay chain of lead-212 includes the shortlived isotopes bismuth-212 by beta decay, polonium-212 by beta decay, and thallium-208 by alpha decay of the bismuth, with further alpha and beta decays respectively to Pb-208, all over about an hour.
  • Radioisotopes for use with compositions and methods described herein include Holmium-166, having a 26 hour half-life and conventionally used for treatment of liver tumor; Dysprosium-165, having a 2 hour half-life and conventionally used as aggregated hydroxide for synovectomy treatment of arthritis; Erbium-169, having a 9.4 day half-life and conventionally used for relieving arthritis pain in synovial joints; Holmium-166, having a 26 hour half-life and conventionally used for treatment of liver tumors; lodine-125, having a 60 day half-life and conventionally used in cancer brachytherapy, including prostate and brain; lridium-192, a beta emitter having a 74 day half-life; Rhenium-186, having a 3.8 day half-life, conventionally used for pain relief in bone cancer; Rhenium-188, having a 17 hour half-life, conventionally used to beta irradiate coronary arteries; Samarium-153, having a 47 hour half half-
  • exemplary radioisotopes for use with compositions and methods described herein include those with a half-life that matches the biological half life of the treatment material.
  • Radioisotopes can be obtained from a variety or commercial or research sources including, but not limited to MDS Nordion, IRE, Covidien, NTP, ANSTO, and Isotop-NIIAR.
  • a conjugated or coupled radioisotope can be administered by route of a substrate comprising a gelatin matrix in the form of gelfoam, gelfoam tiles, gelfoam paste, gel with thixotropic, gelling, or adherent properties.
  • a radioisotope can be coupled to a receptor by any method known in the art (e.g., chelation).
  • a radioisotope can be coupled to the receptor with a DOTA chelation agent.
  • an radioisotope can be an unchelated radioisotopic
  • microparticles or nanoparticles directly encapsulated in latex or similar material which is biotinylated, and then admixed and evenly dispersed into an avidin-gelatin composition (e.g., avidin-gelfoam matrix).
  • an avidin-gelatin composition e.g., avidin-gelfoam matrix
  • a conjugated or coupled radioisotope can be administered by any conventional route.
  • a conjugated radioisotope can be delivered through infusion (e.g., into the bloodstream) or ingestion.
  • yttrium-90 radioactive glass or resin microspheres e.g., SIR- Spheres and TheraSphere
  • a receptor such as biotin
  • Such microspheres can be used in treatment approach known as selective internal radiation therapy.
  • the microspheres can be approximately 30 pm in diameter and can be delivered directly into an artery supplying blood to the tumors.
  • Such treatments can begin by guiding a catheter up through the femoral artery in the leg, navigating to the desired target site and administering treatment.
  • a molecule or substrate coupled to a ligand such as avidin or biotin, can be introduced into tissue at, in or near a tumor. Blood feeding the tumor can carry the microspheres directly to the tumor, allowing specific binding to the ligand-coupled molecule or substrate, thus providing a more selective approach than traditional systemic chemotherapy.
  • a receptor e.g., biotin
  • strontium-89 or samarium (153Sm) lexidronam can be used in the treatment of bone metastasis from cancer.
  • the coupled radioisotopes can travel selectively to areas of damaged bone, in or around which have been introduced a ligand (e.g., avidin or streptavidin) coupled to a molecule or substrate, and spare normal undamaged bone.
  • a receptor e.g., biotin
  • ibritumomab tiuxetan i.e., Zevalin
  • Zevalin an FDA approved anti-CD20 monoclonal antibody conjugated to yttrium-90.
  • a receptor e.g., biotin
  • Such medications can be used for, e.g., the treatment of refractory non-Hodgkin's lymphoma according to approaches described herein.
  • Coupling can be any type attraction, link, or reaction that serves to immobilize a ligand on a molecule. Coupling can be via a bond.
  • a radioisotope-receptor bond is understood as an attraction between atoms of a radioisotope and atoms of a receptor that allows the formation of a linkage between atoms of the biomolecule and the matrix material.
  • a bond can be caused by an electrostatic force of attraction between opposite charges, either between electrons and nuclei, or as the result of a dipole attraction.
  • a bond (e.g., between a
  • biomolecule and a matrix material can be, for example, a covalent bond, a coordinate covalent bond, an ionic bond, polar covalent, a dipole-dipole interaction, a London dispersion force, a cation-pi interaction, or hydrogen bonding.
  • a receptor e.g., a biotin
  • a receptor can be coupled to a radioisotope so as to provide targeted radiotherapy via selective binding to a molecule or substrate coupled to a ligand.
  • a receptor can be selective or non-selective for a ligand.
  • a receptor can be preferably selective for a ligand (or vice versa, a ligand can be preferably selective for a receptor).
  • Biotin e.g., a biotin
  • a receptor can be a biotin.
  • a biotin can be a water soluble B-complex vitamin (e.g., vitamin B 7 , vitamin H, or coenzyme R).
  • a biotin can be a heterocyclic sulfur-containing (mono-)carboxylic acid.
  • a biotin can comprise an imidazole ring and thiophene ring fused.
  • a biotin can comprise a ureido (tetrahydroimidizalone) ring fused with a tetrahydrothiophene ring, optionally with a veleric acid substituent on a carbon of the tetrahydrothiophene ring.
  • Streptavidin or avidin can bind biotin with high affinity (e.g., K d of 10 "14 mol/L to 10 "15 mol/l) and specificity.
  • a biotin can be any commercially available biotin (e.g., Invitrogen; Qiagen; Thermo).
  • a biotin be a variant compound of a naturally occurring biotin that retains or substantially retaining high affinity for streptavidin.
  • a biotin can have a structural formula according to C10 H16 03 N2 S.
  • a biotin can have a structure as follows:
  • Biotin can be attached to a molecule or substrate by biotinylation. Biotinylated proteins of interest can be isolated from a sample by exploiting this highly stable interaction.
  • HABA (2-(4-hydroxyazobenzene) benzoic acid) assay can be used to determine the extent of biotinylation.
  • HABA dye can be bound to avidin or streptavidin and yields a characteristic absorbance. When biotinylated proteins or other molecules are introduced, the biotin displaces the dye, resulting in a change in absorbance at 500 nm. This change can be directly proportional to the level of biotin in the sample.
  • a HABA assay can require a relatively large amount of sample.
  • Extent of biotinylation can also be measured by streptavidin gel-shift, since
  • streptavidin remains bound to biotin during agarose gel electrophoresis or polyacrylamide gel electrophoresis.
  • the proportion of target biotinylated can be measured via the change in band intensity of the target with or without excess streptavidin, seen quickly and quantitatively by Coomassie Brilliant Blue staining.
  • Biotinylation also called biotin labeling, can be most commonly performed through chemical means, although enzymatic methods are also available. Chemical biotinylation can use various conjugation chemistries to yield a nonspecific biotinylation of amines,
  • Biotinylation reagents can include a reactive group attached via a linker to the valeric acid side chain of biotin. Because the biotin binding pocket in avidin or streptavidin can be buried beneath the protein surface, a biotinylation reagent possessing a longer linker can be desirable, as such longer linker can enable the biotin molecule to be more accessible to binding avidin, streptavidin, or Neutravidin. A linker can also mediate the solubility of a biotinylation reagent. Linkers that incorporate poly(ethylene) glycol (PEG) can make water-insoluble reagents soluble or increase the solubility of biotinylation reagents that are already soluble to some extent.
  • PEG poly(ethylene) glycol
  • Biotin can be conjugated to an amine group on the molecule or substrate.
  • a primary amine group can be present as a lysine side chain epsilon-amine or N-terminal a-amine.
  • Amine-reactive biotinylation reagents can be divided into two groups based on water solubility.
  • NHS N-hydroxysuccinimide esters
  • organic solvents for this purpose can include dimethyl sulfoxide (DMSO) and dimethyl formamide (DMF).
  • DMSO dimethyl sulfoxide
  • DMF dimethyl formamide
  • Sulfo-NHS esters are more soluble in water and can be dissolved in water just before use because they hydrolyze easily.
  • the water solubility of sulfo-NHS-esters can be due at least in part from a sulfonate group on the N-hydroxysuccinimide ring. Water solubility can eliminate a need to dissolve the reagent in an organic solvent. Sulfo-NHS-esters of biotin do not penetrate the cell membrane.
  • the chemical reactions of NHS- and sulfo-NHS esters can be identical, in that they can both react spontaneously with amines to form an amide bond. Because the target for the ester is a deprotonated primary amine, the reaction can be favored under basic conditions (above pH 7). Hydrolysis of the NHS ester can be a major competing reaction, and the rate of hydrolysis increases with increasing pH. NHS- and sulfo-NHS-esters have a half-life of several hours at pH 7 but only a few minutes at pH 9. There can be additional flexibility in the conditions for conjugating NHS-esters to primary amines.
  • Incubation temperatures can range from about 4-37 °C, pH values in the reaction range from about 7-9, or incubation times range from a few minutes to about 12 hours.
  • Buffers containing amines e.g., Tris or glycine
  • An alternative to primary amine biotinylation can be to label sulfhydryl groups with biotin.
  • Sulfhydryl-reactive groups such as maleimides, haloacetyls, or pyridyl disulfides, can require free sulfhydryl groups for conjugation; disulfide bonds can be first reduced to free up the sulfhydryl groups for biotinylation. If no free sulfhydryl groups are available, lysines can be modified with various thiolation reagents (Traut's Reagent, SAT(PEG4), SATA and SATP), resulting in the addition of a free sulfhydryl.
  • Sulfhydryl biotinylation can be performed at a slightly lower pH (e.g., about 6.5-7.5) than labeling with NHS esters.
  • Biotinylation reagents that target carboxyl groups do not have a carboxyl-reactive moiety per se but instead rely on a carbodiimide crosslinker such as EDC to bind the primary amine on a biotinylation reagent to a carboxyl group on the target.
  • a carbodiimide crosslinker such as EDC
  • Biotinylation at carboxyl groups can occur at a pH of about 4.5-5.5.
  • buffers should not contain primary amines (e.g., Tris, glycine) or carboxyls (e.g., acetate, citrate).
  • primary amines e.g., Tris, glycine
  • carboxyls e.g., acetate, citrate.
  • Glycoproteins can be biotinylated by modifying the carbohydrate residues to
  • aldehydes which can then react with hydrazine- or alkoxyamine-based biotinylation reagents.
  • Sodium periodate can oxidize a sialic acid on glycoproteins to aldehydes to form these stable linkages at a pH of about 4-6.
  • Antibodies can be heavily glycosylated, and because glycosylation does not interfere with the antibody activity, biotinylating the glycosyl groups can be an ideal strategy to generate biotinylated antibodies.
  • Biotinylation at carboxyl groups can occur at a pH of about 4.5-5.5.
  • buffers should not contain primary amines (e.g., Tris, glycine) or carboxyls (e.g., acetate, citrate).
  • Oligonucleotides can be readily biotinylated in the course of oligonucleotide synthesis by the phosphoramidite method using, e.g., commercial biotin phosphoramidite. Upon the standard deprotection, the conjugates obtained can be purified using reverse-phase or anion- exchange HPLC.
  • Photoactivatable biotinylation reagents can be useful when primary amines
  • a photoactivatable biotinylation reagent relies on aryl azides, which become activated by ultraviolet light (UV; >350 nm), which then react at C-H and N-H bonds.
  • a photoactivatable biotinylation reagent can also be used to activate biotinylation at specific times by simply exposing the reaction to UV light at the specific time or condition.
  • Coupling can be any type attraction, link, or reaction that serves to immobilize a therapeutic agent on a molecule/substrate; a ligand on a molecule/substrate; or a receptor on a radioisotope (or vice versa, a receptor on a molecule/substrate or ligand on a radioisotope).
  • Coupling can be via a bond.
  • a molecule-therapeutic agent bond is understood as an attraction between atoms of a molecule and atoms of a therapeutic agent that allows the formation of a linkage between atoms of the therapeutic agent and the matrix material.
  • a molecule-ligand bond is understood as an attraction between atoms of a molecule and atoms of a ligand that allows the formation of a linkage between atoms of the biomolecule and the matrix material.
  • a bond can be caused by an electrostatic force of attraction between opposite charges, either between electrons and nuclei, or as the result of a dipole attraction.
  • a bond (e.g., between a biomolecule and a matrix material) can be, for example, a covalent bond, a coordinate covalent bond, an ionic bond, polar covalent, a dipole-dipole interaction, a London dispersion force, a cation-pi interaction, or hydrogen bonding.
  • Coupling can be reversible or irreversible. One of ordinary skill will understand that coupling does not necessarily need to be irreversible and can be preferred to be reversible coupling.
  • a ligand or therapeutic agent can be considered to be bound to a substrate (e.g., talc) if the ligand or therapeutic agent was detected on the substrate (e.g., via flow cytomoetry) after washing (e.g., with PBS).
  • a substrate e.g., talc
  • heterologous DNA sequence "exogenous DNA segment” or
  • heterologous nucleic acid each refer to a sequence that originates from a source foreign to the particular host cell or, if from the same source, is modified from its original form.
  • a heterologous gene in a host cell includes a gene that can be
  • DNA shuffling endogenous to the particular host cell but has been modified through, for example, the use of DNA shuffling.
  • the terms also include non-naturally occurring multiple copies of a naturally occurring DNA sequence.
  • the terms refer to a DNA segment that can be foreign or heterologous to the cell, or homologous to the cell but in a position within the host cell nucleic acid in which the element is not ordinarily found. Exogenous DNA segments are expressed to yield exogenous polypeptides.
  • a "homologous" DNA sequence can be a DNA sequence that is naturally associated with a host cell into which it can be introduced.
  • Expression vector, expression construct, plasmid, or recombinant DNA construct is generally understood to refer to a nucleic acid that has been generated via human
  • the expression vector can be part of a plasmid, virus, or nucleic acid fragment.
  • the expression vector can include a nucleic acid to be transcribed operably linked to a promoter.
  • a “promoter” is generally understood as a nucleic acid control sequence that directs transcription of a nucleic acid.
  • An inducible promoter is generally understood as a promoter that mediates transcription of an operably linked gene in response to a particular stimulus.
  • a promoter can include necessary nucleic acid sequences near the start site of transcription, such as, in the case of a polymerase II type promoter, a TATA element.
  • a promoter can optionally include distal enhancer or repressor elements, which can be located as much as several thousand base pairs from the start site of transcription.
  • a "transcribable nucleic acid molecule” as used herein refers to any nucleic acid molecule capable of being transcribed into a RNA molecule. Methods are known for introducing constructs into a cell in such a manner that the transcribable nucleic acid molecule can be transcribed into a functional mRNA molecule that can be translated and therefore expressed as a protein product. Constructs may also be constructed to be capable of expressing antisense RNA molecules, in order to inhibit translation of a specific RNA molecule of interest.
  • the "transcription start site” or “initiation site” can be the position surrounding the first nucleotide that can be part of the transcribed sequence, which can also defined as position +1 . With respect to this site all other sequences of the gene and its controlling regions can be numbered. Downstream sequences (i.e., further protein encoding sequences in the 3' direction) can be denominated positive, while upstream sequences (mostly of the controlling regions in the 5' direction) are denominated negative. "Operably-linked” or “functionally linked” refers preferably to the association of nucleic acid sequences on a single nucleic acid fragment so that the function of one can be affected by the other.
  • a regulatory DNA sequence can be said to be "operably linked to” or “associated with” a DNA sequence that codes for an RNA or a polypeptide if the two sequences are situated such that the regulatory DNA sequence affects expression of the coding DNA sequence (i.e., that the coding sequence or functional RNA can be under the transcriptional control of the promoter).
  • Coding sequences can be operably-linked to regulatory sequences in sense or antisense orientation.
  • the two nucleic acid molecules may be part of a single contiguous nucleic acid molecule and may be adjacent.
  • a promoter can be operably linked to a gene of interest if the promoter regulates or mediates transcription of the gene of interest in a cell.
  • a "construct” is generally understood as any recombinant nucleic acid molecule such as a plasmid, cosmid, virus, autonomously replicating nucleic acid molecule, phage, or linear or circular single-stranded or double-stranded DNA or RNA nucleic acid molecule, derived from any source, capable of genomic integration or autonomous replication, comprising a nucleic acid molecule where one or more nucleic acid molecule has been operably linked.
  • transgenic refers to the transfer of a nucleic acid fragment into the genome of a host cell, resulting in genetically stable inheritance.
  • Host cells containing the transformed nucleic acid fragments are referred to as “transgenic” cells, and organisms comprising transgenic cells are referred to as “transgenic organisms”.
  • Transformed refers to a host cell or organism such as a bacterium, cyanobacterium, animal or a plant into which a heterologous nucleic acid molecule has been introduced.
  • the nucleic acid molecule can be stably integrated into the genome as generally known in the art and disclosed (Sambrook, 1989; Innis, 1995; Gelfand, 1995; Innis & Gelfand, 1999).
  • Known methods of PCR include, but are not limited to, methods using paired primers, nested primers, single specific primers, degenerate primers, gene-specific primers, vector-specific primers, partially mismatched primers, and the like.
  • the term "untransformed” refers to normal cells that have not been through the transformation process.
  • Wild-type refers to a virus or organism found in nature without any known mutation.
  • nucleotide or amino acid sequence identity percent can be understood as the percentage of nucleotide or amino acid residues that are identical with nucleotide or amino acid residues in a candidate sequence in comparison to a reference sequence when the two sequences are aligned. To determine percent identity, sequences are aligned and if necessary, gaps are introduced to achieve the maximum percent sequence identity.
  • Sequence alignment procedures to determine percent identity are well known to those of skill in the art. Often publicly available computer software such as BLAST, BLAST2, ALIGN2 or Megalign (DNASTAR) software can be used to align sequences. Those skilled in the art can determine appropriate parameters for measuring alignment, including any algorithms needed to achieve maximal alignment over the full-length of the sequences being compared.
  • percent sequence identity X/Y100, where X is the number of residues scored as identical matches by the sequence alignment program's or algorithm's alignment of A and B and Y is the total number of residues in B. If the length of sequence A is not equal to the length of sequence B, the percent sequence identity of A to B will not equal the percent sequence identity of B to A.
  • conservative substitutions can be made at any position so long as the required activity can be retained.
  • So-called conservative exchanges can be carried out in which the amino acid which is replaced has a similar property as the original amino acid, for example the exchange of Glu by Asp, Gin by Asn, Val by lie, Leu by lie, and Ser by Thr.
  • Deletion can be the replacement of an amino acid by a direct bond.
  • Positions for deletions include the termini of a polypeptide and linkages between individual protein domains.
  • Insertions are introductions of amino acids into the polypeptide chain, a direct bond formally being replaced by one or more amino acids.
  • Amino acid sequence can be modulated with the help of art-known computer simulation programs that can produce a polypeptide with, for example, improved activity or altered regulation.
  • a corresponding nucleic acid molecule coding for such a modulated polypeptide can be synthesized in-vitro using the specific codon-usage of the desired host cell.
  • Highly stringent hybridization conditions are defined as hybridization at 65 °C in a 6 X SSC buffer (i.e., 0.9 M sodium chloride and 0.09 M sodium citrate). Given these conditions, a determination can be made as to whether a given set of sequences will hybridize by calculating the melting temperature (T m ) of a DNA duplex between the two sequences. If a particular duplex has a melting temperature lower than 65°C in the salt conditions of a 6 X SSC, then the two sequences will not hybridize. On the other hand, if the melting temperature is above 65 °C in the same salt conditions, then the sequences will hybridize.
  • T m melting temperature
  • transfected cells can be selected and propagated to provide recombinant host cells that comprise the expression vector stably integrated in the host cell genome.
  • Exemplary nucleic acids which may be introduced to a host cell include, for example, DNA sequences or genes from another species, or even genes or sequences which originate with or are present in the same species, but are incorporated into recipient cells by genetic engineering methods.
  • exogenous can be also intended to refer to genes that are not normally present in the cell being transformed, or perhaps simply not present in the form, structure, etc. , as found in the transforming DNA segment or gene, or genes which are normally present and that one desires to express in a manner that differs from the natural expression pattern, e.g. , to over-express.
  • exogenous gene or DNA can be intended to refer to any gene or DNA segment that can be introduced into a recipient cell, regardless of whether a similar gene may already be present in such a cell.
  • the type of DNA included in the exogenous DNA can include DNA which can be already present in the cell, DNA from another individual of the same type of organism, DNA from a different organism, or a DNA generated externally, such as a DNA sequence containing an antisense message of a gene, or a DNA sequence encoding a synthetic or modified version of a gene.
  • Host strains developed according to the approaches described herein can be evaluated by a number of means known in the art (see, e.g., Studier, (2005), Protein Expr Purif., 41 (1 ), 207-234; Gellissen, ed. (2005), Production of Recombinant Proteins: Novel Microbial and Eukaryotic Expression Systems, Wiley-VCH, ISBN-10: 3527310363; Baneyx, (2004), Protein Expression Technologies, Taylor & Francis, ISBN-10: 0954523253).
  • RNA interference e.g., small interfering RNAs (siRNA), short hairpin RNA (shRNA), and micro RNAs (miRNA)
  • siRNA small interfering RNAs
  • shRNA short hairpin RNA
  • miRNA micro RNAs
  • RNAi molecules are commercially available from a variety of sources (e.g.
  • siRNA molecule design programs using a variety of algorithms are known to the art (see e.g., Cenix algorithm, Ambion; BLOCK-iTTM RNAi Designer, Invitrogen; siRNA Whitehead Institute Design Tools, Bioinofrmatics & Research Computing). Traits influential in defining optimal siRNA sequences include G/C content at the termini of the siRNAs, Tm of specific internal domains of the siRNA, siRNA length, position of the target sequence within the CDS (coding region), and nucleotide content of the 3' overhangs. FORMULATION
  • compositions described herein can be formulated by any conventional manner using one or more pharmaceutically acceptable carriers or excipients as described in, for example, Remington's Pharmaceutical Sciences (A.R. Gennaro, Ed.), 21 st edition, ISBN: 0781746736 (2005), incorporated herein by reference in its entirety.
  • Such formulations will contain a therapeutically effective amount of a biologically active agent described herein, which can be in purified form, together with a suitable amount of carrier so as to provide the form for proper administration to the subject.
  • the term "formulation” refers to preparing a drug in a form suitable for administration to a subject, such as a human.
  • a “formulation” can include pharmaceutically acceptable excipients, including diluents or carriers.
  • pharmaceutically acceptable can describe substances or components that do not cause unacceptable losses of pharmacological activity or
  • Examples of pharmaceutically acceptable ingredients can be those having monographs in United States Pharmacopeia (USP 29) and National
  • Formulary (NF 24), United States Pharmacopeial Convention, Inc, Rockville, Maryland, 2005 (“USP/NF”), or a more recent edition, and the components listed in the continuously updated Inactive Ingredient Search online database of the FDA.
  • USP/NF United States Pharmacopeial Convention, Inc, Rockville, Maryland, 2005
  • Other useful components that are not described in the USP/NF, etc. may also be used.
  • pharmaceutically acceptable excipient can include any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic, or absorption delaying agents.
  • dispersion media can include any and all solvents, dispersion media, coatings, antibacterial and antifungal agents, isotonic, or absorption delaying agents.
  • the use of such media and agents for pharmaceutical active substances is well known in the art (see generally Remington's Pharmaceutical Sciences (A.R. Gennaro, Ed.), 21 st edition, ISBN: 0781746736 (2005)). Except insofar as any conventional media or agent is incompatible with an active ingredient, its use in the
  • compositions can be contemplated.
  • Supplementary active ingredients can also be incorporated into the compositions.
  • a “stable" formulation or composition can refer to a composition having sufficient stability to allow storage at a convenient temperature, such as between about 0 °C and about 60 °C, for a commercially reasonable period of time, such as at least about one day, at least about one week, at least about one month, at least about three months, at least about six months, at least about one year, or at least about two years.
  • biologically active or inert agents may be in fluid or mechanical communication with the agent(s) or attached to the agent(s) by ionic, covalent, Van der Waals, hydrophobic, hydrophilic or other physical forces.
  • Controlled-release (or sustained-release) preparations may be formulated to extend the activity of the agent(s) and reduce dosage frequency. Controlled-release preparations can also be used to effect the time of onset of action or other characteristics, such as blood levels of the agent, and consequently affect the occurrence of side effects. Controlled-release preparations may be designed to initially release an amount of an agent(s) that produces the desired therapeutic effect, and gradually and continually release other amounts of the agent to maintain the level of therapeutic effect over an extended period of time. In order to maintain a near-constant level of an agent in the body, the agent can be released from the dosage form at a rate that will replace the amount of agent being metabolized or excreted from the body.
  • the controlled-release of an agent may be stimulated by various inducers, e.g., change in pH, change in temperature, enzymes, water, or other physiological conditions or molecules.
  • Agents or compositions described herein e.g., molecule-ligand or radioisotope- receptor
  • therapies described herein one may also provide to the subject other therapies known to be efficacious for treatment of the disease, disorder, or condition.
  • Another aspect provided herein is a process of treating a proliferative disease, disorder, or condition with a composition described herein.
  • the methods and compositions as described herein can allow for pretargeting by a gelatin matrix (e.g., avidin-gelfoam) deposited in a difficult-to-reach surgical area for postoperative radiation as supplied by an intravenously injected biotinylated alpha emitting radioisotope which "finds" and binds to the avidinated matrix.
  • a gelatin matrix e.g., avidin-gelfoam
  • the methods described herein can be used for the treatment of cancer (e.g., bladder) using avidin reagent.
  • Ureters can be appropriately catheterized to isolate the treated bladder from the urinary stream during treatment.
  • Reagent can be deposited in the urinary bladder (by injection or spray) where it binds.
  • a biotinylated radioisotope can be directly introduced into the bladder cavity (e.g., by radiologically guided catheter), where it can bind to avidin on exposed surfaces.
  • radioactive construct can be directly deposited over the tumor or excised tumor site.
  • compositions can include its incorporation into temperature- reversible biocompatible gels (one formulation of several : methylcellulose +
  • Bladder thickness can be controlled by adjusting the volume of a catheter balloon or by filling the bladder with saline or another liquid.
  • Depth of penetration of radiation using different alpha-emitting or short beta emitting isotopes can be carefully calibrated by available software, and by dilution and addition of suspended radiopaque particles or layers incorporated into or on the composition or layer or layers of material used to offset or distance the gel scaffold or avidin from the target site, including using, for example, a gel or gel tiles.
  • the compositions and methods as described herein can be used for treatment of ureteral mucosal tumors by sealing off the affected ureter with balloon catheters above and below the lesion and treating as above or draining the ipsilateral kidney by temporary nephrostomy administered during treatment.
  • compositions e.g., avidin solution, avidinated-gel construct
  • gelfoam and gelatin are FDA approved devices that have been used in humans with limited side effects. Because the individual components incorporated in the constructs have been shown efficacious on their own similar or greater efficacy can be expected when combined.
  • compositions and methods as described herein can provide advantageous properties such as delivery of intense cytotoxic doses of radiotherapy: delivery of radiation at a precise depth of penetration and intensity; variably contoured surfaces of any size in a closely controlled fashion; sparing the underlying parenchyma; or minimizing toxicity to distant organs, particularly bone marrow. This precision is not currently known to be achieved by any known external beam or brachytherapeutic radiation technique.
  • compositions, kits, or methods described herein can be used to treat target tissues.
  • a target tissue can be a tissue associated with a proliferative disease, disorder, or condition.
  • molecule or substrate coupled to a therapeutic agent can be used to treat a proliferative disease, disorder.
  • the therapeutic method can include administration of a molecule or substrate coupled to a therapeutic agent.
  • combination of a first composition including a ligand coupled to molecule or substrate and a second composition including a receptor coupled to a radioisotope can be used to treat a proliferative disease, disorder.
  • a first composition including a ligand coupled to molecule or substrate and a second composition including a receptor coupled to a radioisotope can be used to treat a proliferative disease, disorder.
  • a second composition including a receptor coupled to a radioisotope can be used to treat a proliferative disease, disorder.
  • the therapeutic method can include administration of a first composition including a ligand coupled to molecule or substrate and a second composition including a receptor coupled to a radioisotope.
  • a first composition including a ligand coupled to molecule or substrate
  • a second composition including a receptor coupled to a radioisotope.
  • Exemplary technology for rapidly delivering precisely calibrated and dispersed loads of microparticles into living tissue to depths of 2 cm include the use of catheter-based infusion into periodontal spaces, or air-powered injectors or sprays, and other methods known in the art.
  • Such particles can be infused or injected, e.g., directly into the open space, walls or floor of the cavity created in breast tissue during lumpectomy for cancer, or in retroperitoneal tissues after excision of a pancreatic head cancer, or the cavity created in subcutaneous tissues of the thigh after radical excision of a sarcoma, or in the baldder, lung, fallopian tube or other body cavity.
  • a subject can be given, e.g., an infused or intravenous dose of biotin-labeled radioisotope once monthly for one, two, three or more months, or once or more than once, until the recommended dose and treatment parameters can be achieved.
  • administration can be parenteral, pulmonary, oral, topical, intradermal, intramuscular, intraperitoneal, intravenous,
  • administration can be according to conventional pleurodesis modified to incorporate compositions described herein.
  • a subject in need of the therapeutic methods described herein can be a subject having, diagnosed with, suspected of having, or at risk for developing proliferative disease, disorder, or condition.
  • a determination of the need for treatment will typically be assessed by a history and physical exam consistent with the disease or condition at issue. Diagnosis of the various conditions treatable by the methods described herein is within the skill of the art.
  • the subject can be an animal subject, including a mammal, such as horses, cows, dogs, cats, sheep, pigs, mice, rats, monkeys, hamsters, guinea pigs, and chickens, and humans.
  • the subject can be a human subject.
  • compositions, systems, or methods described herein can be used to treat proliferative diseases, disorders, or conditions.
  • compositions, systems, or methods described herein can be used (e.g., operatively or post-operatively) to treat mesothelioma, Meigs Syndrome, sarcoma, appendiceal carcinoma, pseudomyxoma peritonei, prostate cancer, prostate cancer lymph node dissection beds, rectovesical pouch tumor bed, ovarian cancer resection bed and peritoneal spread, uterine cancer resection cavities, pleural and peritoneal mesothelioma resection bed and peritoneal seeding, colorectal carcinoma, appendiceal carcinoma, pancreatic carcinoma, liver metastases, gastric carcinoma, renal carcinoma, retroperitoneal tumors (sarcomas, carcinomas), breast lumpectomy or breast lymph node dissection cavities, melanoma node dissection cavities, sarcoma resection cavities, head and neck cancer re
  • compositions, systems, or methods described herein can be used at post-operative sites associated with a disease, disorder, or condition described herein.
  • an avidin-talc complex followeded by a receptor-radioisotope complex
  • a receptor-radioisotope complex can be used at
  • an avidin-fibrin glue complex (followed by a receptor-radioisotope complex) can be used at postoperative sites associated with a disease, disorder, or condition described herein.
  • an avidin-gelfoam complex (followed by a receptor-radioisotope complex) can be used at postoperative sites associated with a disease, disorder, or condition described herein.
  • compositions, systems, or methods described herein can be used to treat proliferative diseases, disorders, or conditions.
  • proliferative diseases, disorders, or conditions treatable with compositions described include, but are not limited to, cancer; blood vessel proliferative disorders; fibrotic disorders; mesangial cell proliferative disorders; psoriasis; actinic keratoses; seborrheic keratoses; warts; keloid scars; eczema; and hyperproliferative diseases caused by virus infections, such as papilloma virus infection.
  • Cancer refers generally to any malignant neoplasm or spontaneous growth or proliferation of cells.
  • a subject having "cancer" for example, may have a leukemia, lymphoma, or other malignancy of blood cells.
  • the subject methods are used to treat a solid tumor.
  • Exemplary solid tumors include but are not limited to non- small cell lung cancer (NSCLC), testicular cancer, lung cancer, ovarian cancer, uterine cancer, cervical cancer, pancreatic cancer, colorectal cancer (CRC), breast cancer, as well as prostate, gastric, colon, skin, stomach, esophageal, and bladder cancer.
  • NSCLC non- small cell lung cancer
  • testicular cancer lung cancer
  • lung cancer ovarian cancer
  • uterine cancer cervical cancer
  • pancreatic cancer colorectal cancer
  • breast cancer as well as prostate, gastric, colon, skin, stomach, esophageal, and bladder cancer.
  • Systems and compositions described herein can be used in treatment methods for the above diseases or disorders.
  • Treatment of cancer or treating a subject having cancer can include inhibition of replication of cancer cells, inhibition of spread of cancer, reduction in tumor size, lessening or reducing the number of cancerous cells in the body of a subject, or amelioration or alleviation of symptoms of cancer.
  • a treatment can be considered therapeutic if there can be or is a decrease in mortality or morbidity, and can be performed prophylactically, or therapeutically.
  • Methods described herein can be used to treat (e.g., reduce tumor size, decrease the vascularization, increase the permeability of, or reduce or prevent recurrence of tumor growth) an established tumor.
  • An established tumor is generally understood as a solid tumor of sufficient size such that nutrients, e.g., oxygen, can no longer permeate to the center of the tumor from the subject's vasculature by osmosis and therefore the tumor requires its own vascular supply to receive nutrients.
  • nutrients e.g., oxygen
  • Methods described herein can be used to treat a solid tumor that is not quiescent and can be actively undergoing exponential growth.
  • a therapeutic protocol can be modified according to permeability of a solid tumor.
  • Permeability of a solid tumor generally refers to the permeability of a solid tumor to a therapeutic.
  • a solid tumor may be said to be permeable to a therapeutic if the therapeutic is able to reach cells at the center of the tumor.
  • An agent that increases the permeability of a tumor may for example, normalize, e.g., maintain, the vasculature of a solid tumor.
  • Tumor vascularization or tumor permeability can be determined by a variety of methods known in the art, such as, e.g. by immunohistochemical analysis of biopsy specimens, or by imaging techniques, such as sonography of the tumor, computed tomography (CT) or magnetic resonance imaging (MRI) scans.
  • CT computed tomography
  • MRI magnetic resonance imaging
  • a ligand e.g., therapeutic agent, avidin or streptavidin
  • a ligand e.g., therapeutic agent, avidin or streptavidin
  • a biodegradable or non-biodegradable substrate such as sutures, clips or meshes, implanted adjacent to or within delicate, relatively inaccessible surgically operated areas (e.g., pancreatic head, superior mesenteric artery region) or tumor-cell-contaminated surgical fields (e.g., surface of kidney in contact with a resected retroperitoneal sarcoma) to pre-target the region for postoperative chemotherapy while reducing the risk of radiation injury to the liver or kidney.
  • a cancer treatment system can include avidin or streptavidin-conjugated biodegradable or non-biodegradable microspheres or other particles, introduced into a tumor-associated tissue (e.g., by catheter-based infusion, or air- powered needle-less injection) so to attract biotin-labeled alpha-emitting isotopes (e.g., Radium 223, Bismuth 212) for precisely targeted adjuvant radiotherapy of the surrounding marginal cavity of resected cancers (e.g., sarcoma, breast lumpectomy, pancreatic head, others) appropriate for such treatment, with at least one intent of forestalling local recurrence of tumor.
  • biotin-labeled alpha-emitting isotopes e.g., Radium 223, Bismuth 212
  • a therapeutic agent conjugated to a biodegradable or non- biodegradable substrate such as silica or talc
  • a biodegradable or non- biodegradable substrate such as silica or talc
  • a tumor-cell-contaminated area e.g., a pleural space or surface of kidney in contact with or adjacent to a resected retroperitoneal sarcoma
  • pre-target the region for postoperative chemotherapy or radiotherapy while reducing the risk of additional effects to the tissue or organ (e.g., liver or kidney).
  • a cancer treatment system can include therapeutic agent conjugated to biodegradable or non-biodegradable talc, introduced into a tumor-associated tissue or a cavity of a tumor-associated tissue (e.g., by catheter- based infusion, or air-powered needle-less injection) so to precisely targeted adjuvant therapy of the surrounding marginal cavity of resected cancers (e.g., sarcoma, breast lumpectomy, pancreatic head, others) appropriate for such treatment, with at least one intent of forestalling local recurrence of tumor.
  • resected cancers e.g., sarcoma, breast lumpectomy, pancreatic head, others
  • Pathological tissues e.g., sarcomas
  • Conventional protocols can require a certain margin of tissue around a removed tissue site that does not contain any pathological tissue. For example, in standard sarcoma treatment, if the "clean margin" is less than 1 cm, conventional radiotherapy can be recommended.
  • compositions and methods described herein can provide the extra depth needed (e.g., if only 0.6 cm of the margin is clean, the radiolabeled solution or gelfoam can provide radiotherapy for an additional 0.4 cm of tissue). As such, a patient can be spared the conventional radiotherapy treatment.
  • a general pleurodesis approach using compositions, systems, or methods described herein described herein can be adapted for other indications.
  • a molecule-ligand combination e.g., the talc-avidin
  • a molecule-therapeutic agent combination mixed or suspended in matrix material e.g., a fibrin/gelatin matrix
  • matrix material e.g., a fibrin/gelatin matrix
  • compositions, systems, or methods described herein e.g., molecule-ligand-molecule or radioisotope-receptor
  • molecule-ligand-molecule or radioisotope-receptor can be used as a substitute or
  • radioactive glass spheres are directly injected into the liver vasculature, and because of their size, are held up in small arterioles and precapillaries, where they irradiate the surrounding tissue.
  • the drawbacks of this conventional technique can be the difficulty of controlling the dose without repeat cannulation.
  • Molecule-ligand compositions described herein e.g., talc-avidin
  • a specific size e.g., graded by flow cytometery
  • This approaches imparts greater flexibility in treatment by separating the interventional procedure from the radioactive dose, not requiring radioactive precautions, or allowing choice of isotope and repeated dosing.
  • compositions, systems, or methods described herein can be used as treatment (e.g., adjuvant treatment) of peritoneal carcinomatosis.
  • Peritoneal carcinomatosis can be a frequent complication of ovarian carcinoma, colorectal or especially appendiceal carcinoma, gastric carcinoma, pancreatic carcinoma, peritoneal mesothelioma, or pseudomyxoma peritonei.
  • Conventional treatment of these conditions can employ cytoreductive surgery. In cytoreductive surgery, as much tumor as possible can be surgically resected (e.g., all tumor nodules greater than about 5.0 mm across) then intraoperative "heated" chemotherapy can be given using conventional drugs. Subjects are then observed, with or without additional systemic chemotherapy.
  • a catheter can be placed into the abdominal cavity and additional chemotherapy can be given repeatedly in the outpatient setting.
  • chemotherapy drugs including small molecules such as cisplatin, do not penetrate deeper than 4 or 5 cell layers beneath the peritoneum, or cannot reach tumor cells that are lodged as deep as 2.5 mm below the surface. While intraperitoneal
  • cytotoxic isotope having short range radiation (usually from under about 1 mm to about 5 mm), with minimal marrow toxicity, and direct delivery of the isotope to the peritoneal surfaces.
  • avidin which has a highly positive charged, can adhere to negatively charged normal peritoneal surfaces. When injected into the blood, avidin can be rapidly cleared (e.g., by about 5 hours) and can be cleared from the liver and circulation (e.g., by about 36 hours). Because of the structure of the peritoneal membrane, intraperitoneal ⁇ injected avidin may also be taken up into the circulation or rapidly degraded in the reticuloendothelial system of the liver.
  • liver clearance may be slower (e.g., a few days).
  • Using a branched polyethylene glycolavidin conjugate can slow its exit from the peritoneal compartment while retaining avidin's ability to bind biotin, and its ability to stick to peritoneal surfaces.
  • a therapeutically effective amount of a first composition e.g., a ligand coupled to molecule or substrate
  • a second composition e.g., a receptor coupled to a radioisotope
  • compounds, molecules, substrates, radioisotopes or other compositions or materials of the present disclosure can be administered, at a reasonable benefit/risk ratio applicable to any medical treatment, in a sufficient amount to provide a sufficient therapeutic outcome, as described further herein.
  • an effective amount of a compound described herein is generally that which can exhibit a therapeutic effect (e.g., an anti-proliferative therapeutic effect) to an extent such as to ameliorate the treated disease, disorder, or condition.
  • an effective amount of compositions described herein can be that amount sufficient to affect a desired result on a cancerous cell or tumor, including, but not limited to, for example, inhibiting spread of the disease, disorder, or condition, reducing tumor size, reducing tumor volume,
  • an effective amount of therapy can be the amount that results in a percent tumor reduction or inhibition of more than about 55%, about 60%, about 65%, about 70%, about 75%, about 80%, about 85%, about 90%, about 95%, about 99%, or about 100%.
  • an effective amount of therapy can be sufficient to achieve a desired clinical result, including but not limited to, for example, ameliorating disease, stabilizing a subject, preventing or delaying the development of, or progression of, a proliferative disease, disorder, or condition in a subject.
  • An effective amount of therapy can be determined based on one administration or repeated administration. Methods of detection and measurement of the indicators above are known to those of skill in the art. Such methods include, but are not limited to measuring reduction in tumor burden, reduction of tumor size, reduction of tumor volume, reduction in proliferation of secondary tumors, decreased solid tumor vascularization, expression of genes in tumor tissue, presence of biomarkers, lymph node involvement, histologic grade, and nuclear grade.
  • tumor burden can be determined.
  • Tumor burden also referred to as tumor load, generally refers to a total amount of tumor material distributed throughout the body of a subject.
  • Tumor burden can refer to a total number of cancer cells or a total size of tumor(s), throughout the body, including lymph nodes and bone barrow.
  • Tumor burden can be determined by a variety of methods known in the art, such as, for example, by measuring the dimensions of tumor(s) upon removal from the subject, e.g., using calipers, or while in the body using imaging techniques, e.g., ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) scans.
  • Tumor size can be determined, for example, by determining tumor weight or tumor volume.
  • compositions described herein that can be combined with a pharmaceutically acceptable carrier to produce a single dosage form will vary depending upon the host treated and the particular mode of administration. It will be appreciated by those skilled in the art that the unit content of agent contained in an individual dose of each dosage form need not in itself constitute a therapeutically effective amount, as the necessary therapeutically effective amount could be reached by administration of a number of individual doses.
  • compositions described herein can be determined by standard pharmaceutical procedures in cell cultures or experimental animals for
  • the dose ratio between toxic and therapeutic effects can be the therapeutic index that can be expressed as the ratio LD 5 o/ED 5 o, where large therapeutic indices are preferred.
  • the specific therapeutically effective dose level for any particular subject will depend upon a variety of factors including the disorder being treated and the severity of the disorder; activity of the specific compound employed; the specific composition employed; the age, body weight, general health, sex and diet of the patient; the time of administration; the route of administration; the rate of excretion of the composition employed; the duration of the treatment; drugs used in combination or coincidental with the specific compound employed; and like factors well known in the medical arts (see e.g.
  • compositions may contain such amounts or submultiples thereof to make up the daily dose. It will be understood, however, that the total daily usage of the compounds and compositions of the present disclosure will be decided by an attending physician within the scope of sound medical judgment.
  • treating a state, disease, disorder, or condition includes preventing or delaying the
  • Treating can also include inhibiting the state, disease, disorder, or condition, e.g., arresting or reducing the development of the disease or at least one clinical or subclinical symptom thereof.
  • treating can include relieving the disease, e.g., causing regression of the state, disease, disorder, or condition or at least one of its clinical or subclinical symptoms.
  • a benefit to a subject to be treated can be either statistically significant or at least perceptible to the subject or to a physician.
  • compositions described herein can occur as a single event, a periodic event, or over a time course of treatment.
  • agents can be administered daily, weekly, bi-weekly, or monthly.
  • agents can be administered in multiple treatment sessions, such as 2 weeks on, 2 weeks off, and then repeated twice; or every 3rd day for 3 weeks.
  • a first composition including a ligand coupled to molecule or substrate and a second composition including a receptor coupled to a radioisotope can have the same or different administration protocols.
  • the time course of treatment will usually be at least several days. Certain conditions could extend treatment from several days to several weeks. For example, treatment could extend over one week, two weeks, or three weeks. For more chronic conditions, treatment could extend from several weeks to several months or even a year or more.
  • Treatment in accord with the methods described herein can be performed prior to, concurrent with, or after conventional treatment modalities for a proliferative disease, disorder, or condition.
  • a combination of a first composition including a ligand coupled to molecule or substrate and a second composition including a receptor coupled to a radioisotope can be administered simultaneously or sequentially with another agent, such as an antibiotic, an antiinflammatory, or another agent. Simultaneous administration can occur through another agent, such as an antibiotic, an antiinflammatory, or another agent. Simultaneous administration can occur through another agent, such as an antibiotic, an antiinflammatory, or another agent. Simultaneous administration can occur through
  • compositions each containing one or more of a molecule or substrate, a ligand, a radioisotope, and receptor, an antibiotic, an anti-inflammatory, or another agent.
  • Agents and compositions described herein can be administered according to methods described herein in a variety of means known to the art.
  • the agents and composition can be used therapeutically either as exogenous materials or as endogenous materials.
  • Exogenous agents are those produced or manufactured outside of the body and administered to the body.
  • Endogenous agents are those produced or manufactured inside the body by some type of device (biologic or other) for delivery within or to other organs in the body.
  • administration can be parenteral, pulmonary, oral, topical, intradermal, intramuscular, intraperitoneal, intravenous, subcutaneous, intranasal, epidural, ophthalmic, buccal, or rectal administration.
  • Agents and compositions described herein can be administered in a variety of methods well known in the arts. Administration can include, for example, methods involving infusion, vapor or mist, inhalation, oral ingestion, direct injection (e.g. , systemic or
  • Delivery systems may include, for example, an infusion pump which may be used to administer the agent or composition in a manner similar to that used for delivering insulin or chemotherapy to specific organs or tumors, or antibiotics to specific body cavities.
  • an agent or composition can be administered in combination with a biodegradable, biocompatible polymeric implant that releases the agent over a controlled period of time at a selected site.
  • polymeric materials include polyanhydrides, polyorthoesters, polyglycolic acid, polylactic acid, polyethylene vinyl acetate, and copolymers and combinations thereof.
  • a controlled release system can be placed in proximity of a therapeutic target, thus requiring only a fraction of a systemic dosage.
  • Agents can be encapsulated and administered in a variety of carrier delivery systems.
  • carrier delivery systems include microspheres, hydrogels, polymeric implants, smart polymeric carriers, and liposomes (see generally, Uchegbu and Schatzlein, eds.
  • Carrier-based systems for molecular or biomolecular agent delivery can: provide for intracellular delivery; tailor biomolecule/agent release rates; increase the proportion of biomolecule that reaches its site of action; improve the transport of the drug to its site of action; allow colocalized deposition with other agents or excipients; improve the stability of the agent in vivo; prolong the residence time of the agent at its site of action by reducing clearance; decrease the nonspecific delivery of the agent to non-target tissues; decrease irritation caused by the agent; decrease toxicity due to high initial doses of the agent; alter the immunogenicity of the agent; decrease dosage frequency, improve taste of the product; or improve shelf life of the product.
  • kits can include an agent or composition described herein and, in certain embodiments, instructions for administration. Such kits can facilitate performance of the methods described herein.
  • the different components of the composition can be packaged in separate containers and admixed immediately before use.
  • Components can include, but are not limited to a first composition including a ligand coupled to molecule or substrate and a second composition including a receptor coupled to a radioisotope (or vice versa, a receptor coupled to molecule or substrate and a ligand coupled to a radioisotope).
  • Components can include, but are not limited to, a first composition including a ligand and a second composition including a substrate, wherein the ligand couples to the substrate.
  • Components can include, but are not limited to, a therapeutic agent and a molecule or substrate, wherein the therapeutic agent couples to the substrate.
  • Such packaging of the components separately can, if desired, be presented in a pack or dispenser device which may contain one or more unit dosage forms containing the composition.
  • the pack may, for example, comprise metal or plastic foil such as a blister pack.
  • Such packaging of the components separately can also, in certain instances, permit long- term storage without losing activity of the components.
  • Kits may also include reagents in separate containers such as, for example, sterile water or saline to be added to a lyophilized active component packaged separately.
  • sealed glass ampules may contain a lyophilized component and in a separate ampule, sterile water, sterile saline or sterile each of which has been packaged under a neutral non-reacting gas, such as nitrogen.
  • Ampules may consist of any suitable material, such as glass, organic polymers, such as polycarbonate, polystyrene, ceramic, metal or any other material typically employed to hold reagents.
  • suitable containers include bottles that may be fabricated from similar substances as ampules, and envelopes that may consist of foil-lined interiors, such as aluminum or an alloy.
  • Other containers include test tubes, vials, flasks, bottles, syringes, and the like.
  • Containers may have a sterile access port, such as a bottle having a stopper that can be pierced by a hypodermic injection needle.
  • Other containers may have two compartments that are separated by a readily removable membrane that upon removal permits the components to mix.
  • Removable membranes may be glass, plastic, rubber, and the like.
  • kits can be supplied with instructional materials. Instructions may be printed on paper or other substrate, or may be supplied as an electronic-readable medium, such as a floppy disc, mini-CD-ROM, CD-ROM, DVD-ROM, Zip disc, videotape, audio tape, and the like. Detailed instructions may not be physically associated with the kit; instead, a user may be directed to an Internet web site specified by the manufacturer or distributor of the kit. Compositions and methods described herein utilizing molecular biology protocols can be according to a variety of standard techniques known to the art (see, e.g.
  • Yttrium 90 radiotherapy is a treatment for superficial bladder carcinoma.
  • the rationale for such treatment was developed in a series of preclinical experiments based upon an in vitro microtitre platform illustrated in Example 33 for studying the localization of Yttrium 90 formulations on the inner bladder surface.
  • the mucosal layer of even the contracted normal bladder is rarely greater than about 2 mm, so that the lamina is well within the target range of Y90. While extreme hypertrophic folding may change the average distance between the lumen and the lamina basement, and a solution of isotope within the bladder may not find the crevices in the bladder folds to allow penetration of radiation to the lamina propria, both are unlikely in the absence of severe bladder hypertrophy and fibrosis. Nevertheless, as described above, the most uniform radiation is likely to be applied to at least a partially filled bladder.
  • one or more compositions for treating a patient in such manner includes a preparation of isotope which has a high molecular weight, so that it cannot readily diffuse or leak through either the bladder wall or capillaries that would be exposed during application.
  • the composition includes a carrier or additional component comprising an adhesive, glue or other binding agent, to directly couple or bind the material to bladder mucosa, so as too increase the concentration of isotope at the surface of the bladder.
  • compositions for treating a patient comprises: (a) commercially available clinical grade compounds of Yttrium-90 chelated with 1 ,4,7, 10- tetraazacyclododecane-1 ,4,7, 10-tetraacetic acid (formula (CH 2 CH 2 NCH 2 CO 2 H) 4i also known as DOTA) which consists of a central 12-membered tetraaza (i.e., containing four nitrogen atoms) ring, capable of chelating certain metal ions such as Yttrium, and which is attached by a peptide spacer to biotin; (b) allowing this construct to bind to the therapeutically inert scaffold protein native glycosylated avidin (a 60,000 M.W.
  • the biotin is covalently linked to a spacer such as methylglycine as noted above, and from there to the compound DOTA-Y90.
  • the molecular weight of this construct is approximately 60,000, which would effectively retard its passage through the bladder wall and other membranes.
  • Native glycosylated avidin is a highly positively charged molecule (pl>10), and can readily bind to other large negatively charged molecules such as albumin or fibrinogen, and as shown below, to porcine urinary bladder mucosa at pH ⁇ 7.5. The strong positive charge on the avidin molecule facilitates its
  • a system and method to utilize and apply such a treatment includes a catheter system for instilling the isotope, which would likely include temporary diversion or minimization (by overnight fluid deprivation) of the urinary flow for 6-8 hours, and administration of the isotope after the bladder is emptied.
  • the system and method may also include a sensor for and intra-treatment monitoring of the bladder volume and thickness.
  • a three-dimensional geometrical analysis of various bladder volumes is generated and analyzed to arrive at the proper dose of isotope. For example, one analysis extrapolates from prior reported experiences with intrasynovial injections of Yttrium-90 in which 15 mCi were injected in a 30 ml volume, delivering doses in a 4-6 cGy range.
  • the post-void bladder is distended by 200 ml and a Y90 isotope-conjugated appropriate construct is used which can deliver 3000 rads (6 cGy) to the bladder surface.
  • This embodiment would require 50-60 millicuries of Y90. If appropriate precautions are taken to prevent or counteract isotope leakage, adverse consequences could be minimized.
  • This total dose of Y90 is well within the range currently administered systemically with acceptable, usually temporary untoward effects. In this treatment the majority of isotope would be removed from the body within a matter of hours.
  • escalating doses of Y90-DOTA-Biotin are used to test tolerability of the patient and effectiveness of the treatment.
  • Avidin-Biotin-DOTA-Y90 (ABDY90) is administered in an isotonic protein-free solution of pH 5.5 via a Foley Catheter to overnight- fluid-deprived patients immediately after having voided, and allowing the solution to remain for up to 6 hours (one half-life), then drained and the bladder irrigated.
  • Avidin is a tetrameric or dimeric biotin-binding protein produced in the oviducts of birds, reptiles and amphibians and deposited in the whites of their eggs.
  • avidin makes up approximately 0.05% of total protein (approximately 1 .8 mg per egg).
  • the tetrameric protein contains four identical subunits (homotetramer), each of which can bind to biotin (Vitamin B7, vitamin H) with a high degree of affinity and specificity.
  • the dissociation constant of avidin-biotin is measured to be KD ⁇ 10 "15 M, making it one of the strongest known non-covalent bonds.
  • avidin In its tetrameric form, avidin is estimated to be between 66-69 kDa in size. 10% of the molecular weight is attributed to carbohydrate content composed of four to five mannose and three N-acetylglucosamine residues. The carbohydrate moieties of avidin contain at least three unique oligosaccharide structural types that are similar in structure and composition. Functional avidin is found only in raw egg, as the biotin avidity of the protein is destroyed by cooking. The natural function of avidin in eggs is not known, although it has been postulated to be made in the oviduct as a bacterial growth-inhibitor, by binding biotin to the bacteria.
  • Intravenous Avidin has been found to be an effective "clearing agent" for freely circulating irrelevant biotinylated moieties without compromising pretargeted biotinylated therapeutics access to their appropriate targets. Based on experimentation undertaken, Avidin will bind tightly to porcine bladder mucosa, and in turn will facilitate the binding of biotinylated enzyme-tagged biotin. The binding is best in protein free saline at pH of 8.0 and below, conditions easily achievable in the urinary bladder for periods of up to 6 hours (See Example 34).
  • numbers expressing quantities of ingredients, properties such as molecular weight, reaction conditions, and so forth, used to describe and claim certain embodiments of the present disclosure are to be understood as being modified in some instances by the term "about.”
  • the term “about” is used to indicate that a value includes the standard deviation of the mean for the device or method being employed to determine the value.
  • the term “about” is meant to convey a deviation of up to and including ten percent (10%).
  • the term “about” is meant to convey a deviation of ten percent (10%).
  • the numerical parameters set forth in the written description and attached claims are
  • EXAMPLE 1 BINDING CAPACITY OF BIOTIN-RHODAMINE AND ANTI-AVIDIN-FITC TO TALC
  • Example 2 determined if talc naturally binds to proteins without cross- linkers or chemical reactions.
  • Talc was used as nanoparticles to bind to Anti-Avidin FITC and Biotin Rhodamine. This combinant nanoparticle was observed under microscopy for efficiency and efficacy.
  • Sterile Talc powder (Bryan Corporation, Cat #: 1690, Lot #: 3M021 , Exp. Date: Dec. 2016)
  • PBS (10x) (Sigma cat. #: P5493, lot #: SLBH0296) Day 1 : 1 . Take 30 mg of Talc and mix with 1 ml_ of 1x PBS
  • EXAMPLE 2 AVIDIN AND AVIDIN-RHODAMINE BINDING TO TALC
  • Example 2 determined if the binding of Avidin and Avidin/Rhodamine to talc can be destroyed by washing with either PBS or PBS followed by 0.2% EDTA.
  • -Avidin Rhodamine Add 1 mL of water to 2 mg of Avidin producing a molecular weight of 66 kDa and a Molarity of 30.3 ⁇ . Because the above was not enough to use for the experiment, it was mixed with pure Avidin and then added to the talc.
  • EXAMPLE 3 BINDING AVIDIN TO STERILE TALC POWDER
  • the following Example defined the Avidin plateau (i.e., concentration of Avidin which fully saturates 100 mg of talc) and determined the release of Avidin from talc surface during subsequent washings.
  • 100 mg of sterile Talc was mixed with different concentrations of Avidin (i.e., 50 ⁇ , 5 ⁇ , 0.5 ⁇ , 50 nM, 5 nM) overnight at 4 °C in 0.5 mL of PBS. After the incubation period, wash talc 3x with 1 mL PBS and 3x with 0.5 mL of 0.2% EDTA. Collect the supernatant liquid from two tubes containing the two highest concentrations of Avidin at varying points.
  • Tube 1 - has the highest concentration of Avidin
  • Tube 5- has the lowest concentration of Avidin.
  • Talc is sterile and free of asbestos. The shape is similar to a nugget, and the calculations will substitute it's geometry with spheres. The Talc is calibrated to the distribution of 90% particles at size from 30 pm to 35 pm. Less than 5%is below that range, and above that range.
  • Example 2 determined the Avidin plateau by exposing 100 mg of talc to significantly higher concentrations of Avidin.
  • Example 2 determined if talc binding to FITC-Biotin/Rhodamine and anti- Avidin-FITC can be analyzed by Flow Cytometry.
  • the following Example shows the size and shape of talc does not preclude analysis of talc samples by Flow Cytometry.
  • the aim of the below study was to determine if the Flow Cytometry can successfully analyze 50 mg of Talc added to Anti-Avidin FITC and Biotin Rhodamine.
  • the study showed that the size and shape of the talc samples can be successfully run through the Flow Cytometry instruments as the level of the dye is detectable. Thus, the study showed FITC and Rhodamine present on the surface of talc is detectable.
  • EXAMPLE 6 VARYING CONCENTRATIONS OF TALC INCUBATED WITH HRP-AVIDIN IN 96- WELL PLATES TO DETERMINE THE PLATEAU
  • Example 4 attempted to determine the plateau by using decreasing amounts of talc exposed to HRP-Avidin because increasing the amount of Avidin was not successful in determining the plateau (see e.g., Example 4).
  • the aim of this study was to define the plateau (the full saturation of Talc) by incubating small amounts of Talc in a 96 well plate with different concentrations of HRP Avidin.
  • Stop Solution 2 (ENZO, Cat. #: 80-0377, Lot #: 03191306) Day 1 :
  • talc mg 40 ng/ml 20 ng/ml 10 ng/ml 5 ng/ml
  • talc mg 40 ng/ml 20 ng/ml 10 ng/ml 5 ng/ml
  • the aim of the study was to minimize the amount of Talc in the 96 well microplates by using increments of 20 mg, 10 mg, 5 mg, and 1 mg of Talc added to HRP Avidin to determine the point of full saturation of Talc.
  • EXAMPLE 8 SATURATION OF AVIDIN TO TALC (CONTINUATION OF EXPERIMENT TO
  • Example attempted to determine the plateau by utilizing small amounts of talc using mixtures of containing varying concentrations of labeled and unlabeled Avidin.
  • HRP Avidin stock solution 90 ⁇ of PBS + 10 ⁇ of 1 : 100 HRP Avidin stock
  • mg/well 40 mg/well 40 ng/ml+70 mg/ml 20 ng/ml+35 mg/ml 10 ng/ml+17.5 mg/ml 5 ng/ml+8.75 mg/ml 2.5 ng/ml+4.37 1.25 ng/ml+2.18 mg/ml mg/ml
  • mg/well 40 mg/well 40 ng/ml+70 mg/ml 20 ng/ml+35 mg/ml 10 ng/ml+17.5 mg/ml 5 ng/ml+8.75 mg/ml 2.5 ng/ml+4.37 1.25 ng/ml+2.18 mg/ml mg/ml
  • Example incubated talc with varying concentrations of bleomycin and determined the efficiency of binding with fluorescent microscopy.
  • talc 50 mg was incubated with different concentrations of bleomycin and the efficiency of binding was determined under the fluorescent microscope.
  • bleomycin Reconstitute bleomycin by adding 100 ⁇ of water to 1 mg of bleomycin. Get the concentration to 10 mg/mL and mix, keeping the drug at 4 °C.
  • EXAMPLE 10 "HOT” AND “COLD” AVIDIN MIX BINDS TO TALC (CONTINUATION OF PLATEAU DEFINITION)
  • EXAMPLE 11 BINDING OF BLEOMYCIN TO TALC: A REPEATED EXPERIMENT TO CHECK THE EFFICIENCY WITH FLOW CYTOMETRY
  • Binding Bleomycin to Talc (A Repeated Experiment): Checking The Efficiency Of The Flow Cytometry Purpose: incubate 25 mg talc with different concentration of BLEOMYCIN and check efficiency of binding under flow cytometry.
  • the control sample was placed in the flow cytometer to determine the control light scatter.
  • the emissions were set for 353 and 405 with excitation wavelength set between 244-248 mm and 289-294 mm.
  • Each concentration was placed in the flow cytometer and the data was uploaded.
  • the emissions and excitation wavelength was changed to the values shown in TABLE 34.
  • the data was placed into a graph and exported to a PDF.
  • EXAMPLE 12 "HOT” AND “COLD” AVIDIN MIX BINDS TO TALC (REPEAT OF EXPERIMENT)
  • Example 10 repeated the hot/cold experiment shown in Example 10, with the addition of multiple controls.
  • HRP (Hot) Avidin 1 . Prepare 10 mL of 40 ng/mL (or 260 mM) HRP Avidin in 1x PBS using 5.75 mg/mL or 32.5 ⁇ of HRP Avidin stock solution.

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Abstract

L'invention porte sur une méthode de traitement d'une maladie, d'un trouble, ou d'un état prolifératifs, comprenant un agent thérapeutique et un substrat.
PCT/US2017/044237 2016-07-27 2017-07-27 Composé pour radiothérapie. WO2018022929A1 (fr)

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WO2019195466A1 (fr) * 2018-04-03 2019-10-10 The Trustees Of Columbia University In The City Of New York Composition pour radiothérapie et utilisations associées
WO2021189052A1 (fr) * 2020-03-20 2021-09-23 Robert Taub Composition pour radiothérapie des dépôts tumoraux intracavitaires ou métastasiques et méthode de traitement associée

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WO2015112636A1 (fr) * 2014-01-21 2015-07-30 The Trustees Of Columbia University In The City Of New York Compositions pour radiothérapie et leurs utilisations

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WO2015112636A1 (fr) * 2014-01-21 2015-07-30 The Trustees Of Columbia University In The City Of New York Compositions pour radiothérapie et leurs utilisations
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WO2019195466A1 (fr) * 2018-04-03 2019-10-10 The Trustees Of Columbia University In The City Of New York Composition pour radiothérapie et utilisations associées
WO2021189052A1 (fr) * 2020-03-20 2021-09-23 Robert Taub Composition pour radiothérapie des dépôts tumoraux intracavitaires ou métastasiques et méthode de traitement associée
US11344638B2 (en) 2020-03-20 2022-05-31 Robert Norman Taub Composition for radiation treatment of intracavitary or metastatic deposits of malignancy and method for treatment therewith

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