For many locally advanced tumors, the chemotherapy–radiotherapy
(CT–RT) combination (“chemoradiation”) is currently
the standard of care. Intratumoral (IT) CT-based chemoradiation has
the potential to overcome the limitations of conventional systemic
CT–RT (side effects). For maximizing the benefits of IT CT–RT,
our laboratory has previously developed a radiation-controlled drug
release formulation, in which anticancer drug paclitaxel (PTX) and
radioluminescent CaWO4 (CWO) nanoparticles (NPs) are co-encapsulated
with poly(ethylene glycol)–poly(lactic acid) (PEG-PLA) block
copolymers (“PEG-PLA/CWO/PTX NPs”). These PEG-PLA/CWO/PTX
NPs enable radiation-controlled release of PTX and are capable of
producing sustained therapeutic effects lasting for at least one month
following a single IT injection. The present article focuses on discussing
our recent finding about the effect of the stereochemical structure
of PTX on the efficacy of this PEG-PLA/CWO/PTX NP formulation. Stereochemical
differences in two different PTX compounds (“PTX-S”
from Samyang Biopharmaceuticals and “PTX-B” from Biotang)
were characterized by 2D heteronuclear/homonuclear NMR, Raman spectroscopy,
and circular dichroism measurements. The difference in PTX stereochemistry
was found to significantly influence their water solubility (WS);
PTX-S (WS ≈ 4.69 μg/mL) is about 19 times more water
soluble than PTX-B (WS ≈ 0.25 μg/mL). The two PTX compounds
showed similar cancer cell-killing performances in vitro when used as free drugs. However, the subtle stereochemical difference
significantly influenced their X-ray-triggered release kinetics from
the PEG-PLA/CWO/PTX NPs; the more water-soluble PTX-S was released
faster than the less water-soluble PTX-B. This difference was manifested
in the IT pharmacokinetics and eventually in the survival percentages
of test animals (mice) treated with PEG-PLA/CWO/PTX NPs + X-rays in
an in vivo human tumor xenograft study; at short
times (<1 month), concurrent PEG-PLA/CWO/PTX-S NPs produced a greater
tumor-suppression effect, whereas PEG-PLA/CWO/PTX-B NPs had a longer-lasting
radio-sensitizing effect. This study demonstrates the importance of
the stereochemistry of a drug in a therapy based on a controlled release
formulation.