Microenvironmentally Responsive Chemotherapeutic Prodrugs and CHEK2 Inhibitors Self-Assembled Micelles: Protecting Fertility and Enhancing Chemotherapy

  • Adv Mater. 2023 Mar;35(11):e2210017. doi: 10.1002/adma.202210017.
Meng Wu  1  2  3 ,  Liru Xue  1  2  3 ,  Yican Guo  1  2  3 ,  Xiaoqi Dong  4 ,  Zhaojun Chen  4 ,  Simin Wei  1  2  3 ,  Xiaoqing Yi  5 ,  Yinuo Li  1  2  3 ,  Jinjin Zhang  1  2  3 ,  Su Zhou  1  2  3 ,  Mingfu Wu  1  2  3 ,  Xiaoding Lou  4 ,  Jun Dai  1  2  3 ,  Fan Xia  4 ,  Shixuan Wang  1  2  3
Affiliations
  • 1. Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
  • 2. National Clinical Research Center for Obstetrical and Gynecological Diseases, Wuhan, 430030, China.
  • 3. Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Wuhan, 430030, China.
  • 4. State Key Laboratory of Biogeology and Environmental Geology, Faculty of Materials Science and Chemistry, China University of Geosciences, Wuhan, 430074, China.
  • 5. Key Laboratory of Biomaterials and Biofabrication in Tissue Engineering of Jiangxi Province, Gannan Medical University, Ganzhou, 341000, China.
PMID: 36528787 DOI: 10.1002/adma.202210017
Abstract

Chemotherapy is a widely used and effective Adjuvant treatment for Cancer, and it has unavoidable damage to female fertility, with statistics showing 38% of women who have received chemotherapy are infertile. How to reduce fertility toxicity while enhancing the oncologic chemotherapy is a clinical challenge. Herein, co-delivery micelles (BML@PMP) are developed, which are composed of a reduction-sensitive paclitaxel prodrug (PMP) for chemotherapy and a CHEK2 inhibitor (BML277) for both fertility protection and chemotherapy enhancement. BML@PMP achieves fertility protection through three actions: (1) Due to the enhanced permeability and retention (EPR) effect, BML@PMP is more enriched in the tumor, while very little in the ovary (about 1/10th of the tumor). (2) Glutathione (GSH) triggers the release of PTX, and with low levels of GSH in the ovary, the amount of PTX released in the ovary is correspondingly reduced. (3) BML277 inhibits oocyte Apoptosis by inhibiting the CHEK2-TAp63α pathway. Because of the different downstream targets of CHEK2 in tumor cells and oocytes, BML277 also enhances chemotherapeutic efficacy by reducing DNA damage repair which is activated through the CHEK2 pathway. This bidirectional effect of CHEK2 inhibitor-based co-delivery system represents a promising strategy for improving oncology treatment indices and preventing chemotherapy-associated fertility damage.

Keywords
CHEK2 inhibitor; chemotherapy; co-delivery; fertility toxicity; paclitaxel.
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