ABSTRACT

Introduction

Since 1968, inhaled chemotherapy has been evaluated and has shown promising results up to phase II but has not yet reached the market. This is due to technological and clinical challenges that require to be overcome with the aim of optimizing the efficacy and the tolerance of drug to re-open new developments in this field. Moreover, recent changes in the therapeutic standard of care for treating the patient with lung cancer also open new opportunities to combine inhaled chemotherapy with standard treatments.

Areas covered

Clinical and technological concerns are highlighted from the reported clinical trials made with inhaled cytotoxic chemotherapies. This work then focuses on new pharmaceutical developments using dry powder inhalers as inhalation devices and on formulation strategies based on controlled drug release and with sustained lung retention or based on nanomedicine. Finally, new clinical strategies are described in regard to the impact of the immunotherapy on the patient's standard of care.

Expert opinion

The choice of the drug, inhalation device, and formulation strategy as well as the position of inhaled chemotherapy in the patient’s clinical care are crucial factors in optimizing local tolerance and efficacy as well as in its scalability and applicability in clinical practice.

中文翻译：

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吸入细胞毒性化学疗法：临床挑战，最新进展和未来前景

摘要

介绍

自1968年以来，人们就对吸入式化学疗法进行了评估，并显示出令人满意的结果，直到第二阶段，但尚未投放市场。这是由于需要克服技术和临床挑战，目的是优化药物的功效和耐受性，以重新开启该领域的新发展。此外，用于治疗肺癌患者的治疗标准的最新变化也为将吸入式化学疗法与标准疗法相结合提供了新的机会。

覆盖区域

从已报告的吸入细胞毒性化学疗法进行的临床试验中，突出了对临床和技术的关注。然后，这项工作集中于使用干粉吸入器作为吸入装置的新药物开发，以及基于可控药物释放和持续肺滞留或基于纳米药物的制剂策略。最后，针对免疫疗法对患者护理标准的影响，描述了新的临床策略。

专家意见

药物，吸入装置和制剂策略的选择，以及吸入化学疗法在患者临床护理中的位置，是优化局部耐受性和功效以及其在临床实践中的可扩展性和适用性的关键因素。