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Immunity and Cancer Therapy: Present Status and Future Projections 1
Published in Ronald H. Goldfarb, Theresa L. Whiteside, Tumor Immunology and Cancer Therapy, 2020
Cancer chemotherapy has achieved major successes during the past 40 years as a certain percentage of patients with certain types of cancer can now be brought into complete remission by the use of drugs alone or in combination with other modalities of treatment and are free of detectable disease five or more years after therapy. Major difficulties still remain to be overcome, however, before cancer therapeutics can provide curative treatments for many of the so-called common solid tumors. These difficulties are related to the fact that the drugs available to date do not have antitumor-specificity. In addition, they are not sufficiently selective against the tumor: therefore, even a minor degree of resistance at the tumor cell level cannot be overcome by dose increases without incurring unacceptable toxicity. While the search for new antitumor agents continues and is now focused on the increasing availability of new specific sites of intervention, particularly those related to unique tumor cell regulatory mechanisms, other modalities of treatments are being developed which may provide for greater selectivity of antitumor action. Prominent among these are modalities based on the exploitation of antitumor host defenses, whether through a drug-induced modification of regulatory mechanisms of immune responses, or through the administration of immune effectors and/or mediators, or through a modification of tumor cell populations. Indeed by its very nature immunotherapy may provide the kind of selectivity, perhaps even specificity, of antitumor action that has so far eluded chemotherapy.
Principles of systemic treatment
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Cancer chemotherapy is the treatment of malignant disease with drugs rather than radiation or surgical removal. The drugs used are often highly toxic since they are rarely totally selective for cancer cells. They should therefore be given within an oncology unit by those experienced in their use.
Swarm Intelligence and Evolutionary Algorithms for Drug Design and Development
Published in Sandeep Kumar, Anand Nayyar, Anand Paul, Swarm Intelligence and Evolutionary Algorithms in Healthcare and Drug Development, 2019
Considering the medical aspects of chemotherapy drugs for cancer treatment, they all carry quite narrow therapeutic indices. This factor determines the dose level at which the drug consumption would have a significant impact over the tumor area almost reaching out to the values which may cause unacceptable toxic side effects. Hence more efficient treatments may result from balancing both the beneficial factors and the adverse effects as an outcome of combination of the various drugs administered in different dosages over a period of treatment [31]. The positive effects of the chemotherapy treatment here become the treatment objectives, which oncologist aim to achieve via administration of anticancer drug. A cancer chemotherapy treatment is carried out through following method [32]: CurativePalliativeCurative—This treatment is undertaken in order to eradicate the tumor.
Preparation and in vivo evaluation of an intravenous emulsion loaded with an aprepitant-phospholipid complex
Published in Drug Delivery, 2023
Yan Li, Hong Yin, Chensi Wu, Jia He, Chunyan Wang, Bo Ren, Heping Wang, Dandan Geng, Yirong Zhang, Ligang Zhao
From the perspective of the patients, the most unpleasant side effects of cancer chemotherapy are vomiting and nausea. Poor control of these side effects can lead to a decline in quality of life (Ballatori & Roila, 2003). At present, chemotherapy-induced nausea and vomiting (CINV) is mainly prevented by recombination of 5-hydroxytryptamine receptor antagonist (5-HT3RA) with dexamethasone, which still fruitlessly delays CINV (Zhang et al., 2020). Aprepitant (APT) is the only neurokinin-1 receptor antagonist (NK-1, RA) authorized for the prevention of moderately and highly emetogenic chemotherapy-induced CINV (Aapro et al., 2015; Ottoboni et al., 2018). APT is usually combined with other antiemetic drugs in order to prevent acute or delayed CINV (Zhang et al., 2020). Moreover, it can suppress nausea and polyneuropathy semaphore by preventing substance P from interacting with the NK-1 receptor (Tsukiyama et al., 2018). However, poor water-solubility, first-pass metabolism and poor intestinal mucosal permeability may cause low oral bioavailability of APT restrict its application (Hörter & Dressman, 2001; Sato et al., 2014). A few years later, forsaprepitant which was a prodrug of APT, was discovered and authorized for intravenous administration to prevent CINV in 2008. Forsaprepitant is more soluble than APT in water but still uses a powerful surfactant (Tween 80), which gives rise to serious allergic reactions and adverse events (Wang et al., 2020).
Nanoparticle-containing lyophilized dry powder inhaler formulations optimized using central composite design with improved aerodynamic parameters and redispersibility
Published in Pharmaceutical Development and Technology, 2023
Lung and bronchial cancer is the leading cause of cancer-related deaths, with an estimated 236 740 new cases and 350 deaths per day in the USA in 2022 (Siegel et al. 2022). In lung cancer chemotherapy, drugs are typically administered intravenously (iv) into the systemic circulation. However, high doses of iv chemotherapeutics and not applying them to the target area cause high toxicity. Pulmonary administration has emerged as an attractive option in the treatment of lung cancer, as it can overcome these issues associated with iv administration. Inhalers are non-invasive systems that can be used at lower doses with fewer systemic side effects (Guzmán et al. 2019). However, it is still not possible to directly apply drugs to the tumor through inhalation. For this reason, the approach of administering drugs as tumor-targeted nanoparticle systems is frequently investigated.
Cell-derived biomimetic nanocarriers for targeted cancer therapy: cell membranes and extracellular vesicles
Published in Drug Delivery, 2021
Aixue Li, Yunan Zhao, Yixiu Li, Liangdi Jiang, Yongwei Gu, Jiyong Liu
Although many treatments have been developed for cancer, chemotherapy is still the most common treatment. However, the efficiency of chemotherapy is often reduced by multidrug resistance (MDR), which is a difficulty that researchers have been attempting to overcome (Dei et al., 2019; Negi et al., 2019). CCM encapsulates calcium channel antagonists to overcome MDR by regulating intracellular channels in tumor cells. A recent study developed multidrug-resistant cervical cancer cell (HeLa/Dox) membrane-decorated silica NPs for the codelivery of siRNA and Dox (CCM/CS/R-D). The siRNA replaces the commonly used Cav antagonist, reduces the Ca2+ level, and increases the number of cells in the DNA synthesis stage, thus increasing drug retention. Ability of multidrug resistant CCM to bind to homotypic cell membranes and the integrin-associated protein CD47 on CCM endows CCM/CS/R-D with an excellent targeting ability and in vivo escape ability, which are conducive to the efficient arrival and function of DOX and siRNA in tumors (Zhao et al., 2020).