Si tratta di nanoparticelle in grado di attraversare la massa densa che circonda il tumore e di trasportare il medicinale in maniera selettiva nelle cellule malate, in concentrazioni maggiori (+33%) e senza danneggiare i tessuti sani. Cascinu (Aiom): “E’ un’arma efficace per sconfiggere la malattia”.
19 MAR – Oggi è possibile superare la barriera del cancro, finora impermeabile ai farmaci chemioterapici tradizionali. Nanoparticelle, che funzionano come droni, sono in grado di attraversare la massa densa che circonda il tumore e di trasportare il medicinale in maniera selettiva nelle cellule malate, in concentrazioni maggiori (+33%) e senza danneggiare i tessuti sani. Uno di questi farmaci, il Nab paclitaxel (paclitaxel legato all’albumina in nanoparticelle) è già utilizzato con successo nel tumore del seno, che ogni anno nel nostro Paese fa registrare 46mila nuovi casi.
La nanomedicina rappresenta una vera e propria rivoluzione per l’oncologia e apre la strada alla chemioterapia target, la nuova frontiera per sconfiggere il cancro. Per discutere delle prospettive offerte dall’innovazione tecnologica si svolge oggi a Roma un convegno nazionale patrocinato da Aiom (Associazione italiana di oncologia medica) e Sifo (Società italiana di farmacia ospedaliera e dei servizi farmaceutici delle Aziende sanitarie), in cui è prevista la lezione magistrale di Mauro Ferrari, presidente del Methodist Hospital Research Institute di Houston, uno dei più importanti ricercatori al mondo nel campo della nanomedicina.
“Un nanometro – ha spiegato Ferrari – equivale a un miliardesimo di metro. In queste dimensioni le proprietà fisiche della materia e il modo in cui si esprimono le leggi della natura cambiano. Le nanotech modificano radicalmente i principi della lotta al cancro perché aprono nuovi orizzonti nella personalizzazione della terapia”. Una particella di circa 100 nanometri è in grado entrare nella cellula (che ha un diametro compreso fra i 10.000 ai 20.000 nanometri) e di interagire con il DNA e con le proteine.
“Oggi, per la prima volta, siamo di fronte a un sensibile passo in avanti nel trattamento del tumore del pancreas – ha afferma Stefano Cascinu, presidente Aiom – ogni anno in Italia si registrano 11.500 nuove diagnosi. Si tratta di una delle neoplasie a prognosi più infausta: solo il 5% degli uomini e il 6% delle donne risultano vivi a 5 anni, senza sensibili scostamenti nell’ultimo ventennio. In uno studio di fase III Nab paclitaxel con gemcitabina ha infatti evidenziato risultati clinici significativi, con un aumento del 59% nella sopravvivenza a un anno e un tasso raddoppiato a due anni. In questa formulazione vengono sfruttate le potenzialità dell’albumina, una proteina che funziona come un veicolo naturale in grado di trasportare più rapidamente il farmaco attraverso i vasi sanguigni. In queste dimensioni infatti il medicinale è 100 volte più piccolo rispetto a un globulo rosso. L’albumina si lega poi a una proteina, SPARC, presente nelle cellule neoplastiche del pancreas consentendo a maggiori quantità di principio attivo di penetrare nel tumore”.
In questo modo è possibile ottenere livelli di paclitaxel libero nell’organismo 10 volte superiori rispetto a quelli rilasciati dalla formulazione tradizionale e raggiungere concentrazioni più alte del 33% all’interno delle cellule tumorali. Senza provocare reazioni allergiche perché non vengono utilizzati solventi chimici.
I principi della nanotecnologia si applicano anche nella diagnosi radiologica. Uno degli obiettivi è sviluppare traccianti radioattivi legati ad altre sostanze che mirino a punti specifici del tumore. In questo modo sarà possibile disporre di una definizione diagnostica decisamente migliore di quella offerta dai normali mezzi di contrasto. Il Methodist Hospital Research Institute (Tmhri) di Houston, presieduto da Ferrari, è il più importante centro al mondo di ricerca nelle nanotecnologie. È un ente indipendente all’interno di un sistema ospedaliero (Methodist Hospital System). Al Tmhri lavorano 1.200 dipendenti e sono in corso 700 clinical trial (protocolli sperimentali). “La nanotech – ha sottolineato Ferrari – unisce molteplici settori scientifici: sulla scala nanometrica le differenze tra discipline svaniscono. I nanofarmaci infatti non possono che essere il frutto della collaborazione tra clinici, oncologi molecolari, ingegneri, chimici, farmacologi e matematici”.
“Un nuovo trattamento è realmente innovativo quando offre al paziente benefici maggiori rispetto alle opzioni precedentemente disponibili, in termini di efficacia, sicurezza e convenienza – ha dichiarato Laura Fabrizio, presidente di Sifo – il farmacista ospedaliero è coinvolto a pieno titolo nell’introduzione delle nuove tecnologie, come ad esempio le nanotecnologie, ed il suo contributo nell’ambito dell’innovazione è richiesto in tutte le fasi del percorso, dalla valutazione, alla decisione fino al monitoraggio degli esiti. Innovare vuol dire esplorare percorsi, verificare programmi ed esperienze che, a livello centrale o periferico, tentino di dare risposte praticabili, rispettando i principi di equità e sostenibilità che presiedono il sistema sanitario pubblico”.
“La sfida della sostenibilità – ha concluso il Cascinu – per il nostro sistema sanitario, si può vincere garantendo l’accesso a trattamenti con un ottimo rapporto costo/beneficio. La parola d’ordine deve essere appropriatezza”.
Fonte: “Quotidiano.it” – 19 marzo 2013
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