Peritoneal
metastasis (PM) is considered as the terminal stage
of metastatic colon cancer, with still poor median survival rate even
with the best recent chemotherapy treatment. The current PM treatment
combines cytoreductive surgery, which consists of resecting all macroscopic
tumors, with hyperthermic intraperitoneal chemotherapy (HIPEC), which
uses mild hyperthermia to boost the diffusion and cytotoxic effect
of chemotherapeutic drugs. As HIPEC is performed via a closed circulation of a hot liquid containing chemotherapy, it
induces uncontrolled heating and drug distribution in the whole peritoneal
cavity with important off-site toxicity and a high level of morbidity.
Here, we propose a safer precision strategy using near-infrared (NIR)
photoactivated gold nanoparticles (AuNPs) coupled to the chemotherapeutic
drug 5-fluorouracil (5-FU) to enable a spatial and temporal control
of mild chemo-hyperthermia targeted to the tumor nodules within the
peritoneal cavity. Both the 16 nm AuNPs and the corresponding complex
with 5-FU (AuNP–5-FU) were shown as efficient NIR photothermal
agents in the microenvironment of subcutaneous colon tumors as well
as PM in syngeneic mice. Noteworthy, NIR photothermia provided additional
antitumor effects to 5-FU treatment. A single intraperitoneal administration
of AuNP–5-FU resulted in their preferential accumulation in
tumor nodules and peritoneal macrophages, allowing light-induced selective
hyperthermia, extended tumor necrosis, and activation of a pro-inflammatory
immune response while leaving healthy tissues without any damage.
From a translational standpoint, the combined and tumor-targeted photothermal
and chemotherapy mediated by the AuNP–drug complex has the
potential to overcome the current off-target toxicity of HIPEC in
clinical practice.