Advances in image-guided Intratumoral Drug Delivery Techniques

Abstract

Image-guided drug delivery provides a means for treating a variety of diseases with minimal systemic involvement while concurrently monitoring treatment efficacy. These therapies are particularly useful to the field of interventional oncology, where elevation of tumor drug levels, reduction of systemic side effects and post-therapy assessment are essential. This review highlights three such image-guided procedures: transarterial chemoembolization, drug-eluting implants and convection-enhanced delivery. Advancements in medical imaging technology have resulted in a growing number of new applications, including image-guided drug delivery. This minimally invasive approach provides a comprehensive answer to many challenges with local drug delivery. Future evolution of imaging devices, image-acquisition techniques and multifunctional delivery agents will lead to a paradigm shift in patient care.

3D printing of PCL/Fluorouracil tablets by selective laser sintering: Properties of implantable drug delivery for cartilage cancer treatment

“…Combining minimally-invasive treatments with controlled release technology provides opportunities for treating cancers in a safe and effective manner by placing drug-loaded implants directly into solid tumors or in resection cavities. However, it is likely that future chemotherapeutic implants will be optimized for use in a variety of different tumors to maximize patient comfort and survival [7][8][9].…”

Additive Manufacturing of PE/Fluorouracil Waffles for Implantable Drug Delivery in Bone Cancer Treatment

“…Under this scenario, intratumoral drug delivery devices have emerged as a powerful strategy for localized treatment of solid tumors, promising to substantially improve the therapeutic outcomes for several kinds of cancer. This technology allows for controlled and sustained release of the drug into the solid tumors or in the resection cavities, which results in a safer and more effective strategy [14][15][16].…”

Ultrasound-Guided Intratumoral Delivery of Doxorubicin from in Situ Forming Implants in a Hepatocellular Carcinoma Model

“…Since Dox can form crystalline domains at elevated concentrations, we hypothesize that it forms a polyionic complex with the degrading matrix, reducing erosion, and stabilizing the implant microstructure [41,[53][54][55]. These release kinetics provide a means for rapidly achieving a therapeutic dose, followed by lower daily maintenance doses released by the implant [21,23,56]. Polymer millirods, which follow a similar release profile, have shown promise as a local delivery system for treating ectopic lesions [24,25].…”

“…Image-guided techniques for treating HCC include transarterial chemoembolization (TACE), radio frequency ablation (RFA) and image-guided intratumoral drug delivery [18,19]. TACE is a technique which utilizes embolic agents to block the blood flow of the feeding artery of the tumor, and has been successful at reducing the tumor size for patients with nonresectable tumors [20,21]. However, cirrhosis, portal hypertension, limited hepatic reserve and portal vein involvement with the tumor can all limit the effectiveness of TACE [21].…”

“…TACE is a technique which utilizes embolic agents to block the blood flow of the feeding artery of the tumor, and has been successful at reducing the tumor size for patients with nonresectable tumors [20,21]. However, cirrhosis, portal hypertension, limited hepatic reserve and portal vein involvement with the tumor can all limit the effectiveness of TACE [21]. RFA is a minimally invasive technique performed by placing an electrode into the tumor, under image guidance, and applying radio frequency to heat the surrounding tissue [18,19].…”