Ocular and systemic toxicity of high-dose intravitreal topotecan in rabbits: Implications for retinoblastoma treatment Journal Article


Authors: Del Sole, M. J.; Clausse, M.; Nejamkin, P.; Cancela, B.; Del Río, M.; Lamas, G.; Lubieniecki, F.; Francis, J. H.; Abramson, D. H.; Chantada, G.; Schaiquevich, P.
Article Title: Ocular and systemic toxicity of high-dose intravitreal topotecan in rabbits: Implications for retinoblastoma treatment
Abstract: Although many more eyes of children with retinoblastoma are salvaged now compared to just 10 years ago, the control of vitreous seeding remains a challenge. The introduction of intravitreal injection of melphalan has enabled more eyes to be salvaged safely but with definite retinal toxicity. Intensive treatment with high-dose intravitreal topotecan may be a strategy to control tumor burden because of its cell cycle-dependent cytotoxicity and the proven safety in humans. Therefore, we evaluated the ocular and systemic safety of repeated high-dose intravitreal injections of topotecan in rabbits. Systemic and ocular toxicity was assessed in non-tumor-bearing rabbits after four weekly injections of three doses of topotecan (10 μg, 25 μg, and 50 μg) or vehicle alone. Animals were evaluated weekly for general and ophthalmic clinical status. One week after the last injection, vitreous and plasma samples were collected for drug quantification and the enucleated eyes were subjected to histological assessment. Weight, hair loss, or changes in hematologic values were absent during the study period across all animal groups. Eyes injected with all topotecan doses or vehicle showed no signs of anterior segment inflammation, clinical or histologic evidence of damage to the retina, and ERG parameters remained unaltered throughout the study. Vitreous and plasma topotecan lactone concentrations were undetectable. Four weekly intravitreal injections of topotecan up to 50 μg in the animal model or a 100 μg human equivalent dose were not toxic for the rabbit eye. High doses of topotecan may show promising translation to the clinic for the management of difficult-to-treat retinoblastoma vitreous seeds. © 2022
Keywords: topotecan; retinoblastoma; safety; intraocular; intravitreal
Journal Title: Experimental Eye Research
Volume: 218
ISSN: 0014-4835
Publisher: Elsevier Inc.  
Date Published: 2022-05-01
Start Page: 109026
Language: English
DOI: 10.1016/j.exer.2022.109026
PROVIDER: scopus
PUBMED: 35276184
PMCID: PMC9502017
DOI/URL:
Notes: Article -- Export Date: 1 April 2022 -- Source: Scopus
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  1. Jasmine Helen Francis
    256 Francis
  2. David H Abramson
    389 Abramson