ABSTRACT

Introduction: Drug-based treatment regimens for cancer are often associated with off-target toxic side effects and low penetration of the drug at the tumor site leading to patient morbidity and limited efficacy. Loco-regional drug delivery has the potential to increase efficacy while concomitantly reducing toxicity.

Areas covered: Clinical applications using loco-regional delivery include intra-arterial drug delivery in retinoblastoma, direct intra-tumoral (IT) injection of ethanol for ablation in hepatocellular carcinoma (HCC) and the use of HIPEC in peritoneal carcinomas. In recent years, there has been a significant increase in both approved products and clinical trials, with a particular emphasis on drug delivery platforms such as drug-eluting beads for HCC and hydrogel platforms for intravesical delivery in bladder cancer.

Expert opinion: Development of loco-regional drug-delivery systems has been slow, limited by weak clinical data for early applications and challenges relating to dosing, delivery and retention of drugs at the site of action. However, there is increasing focus on the potential of loco-regional drug delivery when combined with bespoke drug-delivery platforms. With the growth in immunotherapies, the use of IT delivery to drive priming of the anti-tumor response has opened up a new field of opportunity for loco-regional drug delivery.

摘要

简介：基于药物的癌症治疗方案通常与脱靶毒副作用和药物在肿瘤部位的低渗透性相关，导致患者发病率和疗效有限。局部区域给药有可能提高疗效，同时降低毒性。

涵盖的领域：使用局部区域递送的临床应用包括视网膜母细胞瘤的动脉内药物递送、直接瘤内 (IT) 注射乙醇以消融肝细胞癌 (HCC) 和 HIPEC 在腹膜癌中的使用。近年来，批准的产品和临床试验都有显着增加，特别强调药物递送平台，例如用于 HCC 的药物洗脱珠和用于膀胱癌膀胱内递送的水凝胶平台。

专家意见：局部区域药物递送系统的发展一直缓慢，受限于早期应用的弱临床数据以及与药物在作用部位的剂量、递送和保留相关的挑战。然而，当与定制的药物递送平台相结合时，人们越来越关注局部区域药物递送的潜力。随着免疫疗法的发展，使用 IT 递送来驱动抗肿瘤反应的启动为局部区域药物递送开辟了新的机会领域。