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Published on: December 1, 2016
Targeted versus chrono-targeted chemotherapy for inhaled chemotherapy in non-small cell lung cancer
Paul Zarogoulidis1, Kaid Darwiche2, George Kalamaras3
1Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; ; Pulmonary Department-Interventional Unit, "Ruhrland" Klinik, University of Duisburg-Essen, Essen, Germany ;
Abstract:
Lung cancer long term survival still remains poor and early detection is still the best methodology to treatment. Therefore several novel approaches have been investigated for anticancer drug administration. Inhaled therapies for lung diseases are used since the ancient times. Inhaled anticancer treatment administration was firstly investigated almost 30 years ago. Since then the inclusion and exclusion criteria have been investigated in correlation with the safety and efficacy of cisplatin, 5-fluoracil, carboplatin, paclitaxel, docetaxel, 9-nitro camptothecine, gemcitabine, cetuximab, granulocyte-colony stimulating factor, interleukins and recently with bevasizumab. Along with the anticancer drug formulations administered, other aspects of this local treatment have been also investigated to improve the efficiency and safety, such as; proper nebulization system, drug formulation delivery system, setting of administration, aerosol protection measures, inhalation techniques and safety issues follow up. During the last years with the use of actigraphy wrist watches, an extended investigation of the circadian rhythm of animals and humans has been performed and new insights are included in lung cancer chemotherapy administration. The "personalized" therapy administration should not be considered only as a molecular pathway inhibition, but also as a chrono-targeted anticancer treatment.
Insights
Early lung cancer detection improves survival. Inhaled anticancer drug delivery, including novel chrono-targeted approaches, enhances treatment efficacy and safety for better patient outcomes.
Area of Science:
- Oncology
- Pulmonology
- Pharmacology
Background:
- Lung cancer long-term survival remains poor, underscoring the need for improved early detection and treatment strategies.
- Inhaled anticancer therapies offer a localized approach to lung disease treatment, with investigations dating back nearly 30 years.
- Numerous anticancer drugs and delivery systems have been explored for inhaled administration, alongside optimizing nebulization, formulation, and safety protocols.
Purpose of the Study:
- To review the evolution and current status of inhaled anticancer drug administration for lung cancer.
- To explore advancements in local treatment delivery systems and safety measures for inhaled chemotherapy.
- To introduce the concept of chrono-targeted therapy, integrating circadian rhythm insights into personalized lung cancer treatment.
Main Methods:
- Literature review of inhaled anticancer agents and administration techniques for lung cancer.
- Analysis of safety and efficacy data for various chemotherapeutic drugs delivered via inhalation.
- Investigation into the role of circadian rhythms and actigraphy in optimizing chemotherapy timing.
Main Results:
- Established safety and efficacy profiles for multiple inhaled anticancer drugs, including cisplatin, paclitaxel, and bevacizumab.
- Identified key factors for optimizing inhaled therapy, such as nebulizer systems, delivery methods, and inhalation techniques.
- Highlighted the emerging importance of chronotherapy, leveraging circadian rhythms for personalized lung cancer treatment.
Conclusions:
- Inhaled anticancer therapy is a viable and evolving treatment modality for lung cancer, with continuous improvements in drug delivery and safety.
- Personalized lung cancer treatment should encompass not only molecular targeting but also chrono-targeted administration based on circadian rhythms.
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