ReviewsPolymer Implants for Intratumoral Drug Delivery and Cancer Therapy
Section snippets
INTRODUCTION
Cancer is an enormous health concern in the United States and in recent years has surpassed heart disease as the predominant cause of death for all but the most elderly Americans.1 Currently, the most curative treatment option for solid tumors is surgical resection followed by adjuvant chemotherapy or radiation therapy to minimize the risk of recurrence. Many cancers respond well to this treatment strategy, but many patients are not eligible for surgical resection. For example, out of 70000
Definition of Pharmacokinetic Goals for Local Drug Delivery to Unresectable Tumors
In considering the use of an intratumoral implant for tumor treatment, it is necessary to consider the generic characteristics that would benefit the device. First, the implant should be able to minimize shortcomings associated with systemically administered chemotherapy. Second, it should provide an optimal drug delivery profile to the tumor, which is to say that it should be able to provide effective drug concentrations to the desired region over a prolonged period of time. Third, the device
Overview of Methods to Investigate Local Drug Release and Tissue Distribution
In developing an intratumoral chemotherapy device, techniques for monitoring local drug concentrations are necessary to optimize implant design. Measuring drug concentration as a function of time provides a quantitative method to compare multiple treatments. Many different techniques can be used to monitor drug release from intratumoral implants. While certain techniques require extraction of tissue and measurement of drug concentration ex vivo, alternate, noninvasive imaging based‐techniques
Drug Distribution and Antitumor Efficacy from Liver Tumor Treatment with Polymer Implants
After extensive pharmacokinetic study of polymer millirods in normal livers, preliminary studies of drug distribution and treatment efficacy in tumor tissue were performed. One study assessed the use of implants alone for treatment and local control of small liver tumors;66 the second study explored drug distribution and therapeutic effects of an approach combining RF ablation followed by implant placement.67 Both of these studies were performed using the rabbit VX2 model of liver carcinoma,
CONCLUSIONS AND FUTURE OUTLOOK
Conventional systemic chemotherapy for tumors is restricted by lack of tumor specificity and severe side effects associated with intrinsic drug toxicity.5., 6., 7. With the emergence of minimally invasive, image‐guided interventional technology, tumor chemotherapy is at the threshold of a major breakthrough because of such technological advances in targeting strategies that overcome the previous limitations. Tumor‐directed therapies, such as focal ablation and locoregional chemotherapy, are
Acknowledgements
This work was supported by the NIH grant R01 CA090696 to JG. BW is supported by a DOD predoctoral fellowship BC043453 and the NIH grant T32 GM07250 to the Case Western Reserve University Medical Scientist Training Program. EB is supported by a NIH minority supplement. This is manuscript CSCNP009 from the “Cell Stress and Cancer Nanomedicine” program in the Simmons Comprehensive Cancer Center at UT Southwestern Medical Center at Dallas.
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