Polymeric prodrugs conjugated with reduction-sensitive dextran–camptothecin and pH-responsive dextran–doxorubicin: an effective combinatorial drug delivery platform for cancer therapy

Multiple drugs in combinatory therapy can improve the treatment of cancer due to their efficient reduction of multidrug resistance (MDR) of tumor cells. In this paper, we first synthesized a reduction-sensitive dextran-ss-camptothecin (Dex-ss-CPT, or Dex-CPT) prodrug conjugated by a disulfide bond, and a pH-responsive dextran-hyd-doxorubicin (Dex-hyd-DOX, or Dex-DOX) prodrug linked with an acid-cleavable hydrazone group. The chemical structures of the intermediate polymers and polymeric prodrugs have been fully characterized by 1H NMR, FT-IR, UV-Vis and HPLC analyses, respectively. Both prodrugs could self-assemble into uniform particles in aqueous solution. Subsequently, in vitro synergistic drug release of the two prodrugs was studied by methyl thiazolyl tetrazolium (MTT) assay. The reduction of a disulfide linker generates a thiol intermediate that is followed by intramolecular cyclization and the cleavage of the neighboring carbonate bridge, thus releasing native CPT molecules from the Dex-ss-CPT micelles. Similarly, the pH-sensitive hydrazone bond is broken under intracellular acidic conditions and the DOX parent drug is released from the Dex-hyd-DOX micelles. Finally, in vivo pharmacokinetics and biodistribution were investigated via intravenous administration with various formulations to treat 4T1 tumor-bearing mice. Meanwhile, the antitumor activity was also studied. This work demonstrates an effective anti-cancer prodrug design platform, which is expected to be useful for the treatment of various tumors.