Feasibility and effectiveness of inhaled carboplatin in NSCLC patients

Abstract

Inhaled carboplatin could be given as an alternative root of pulmonary drug delivery in selected patients, but further randomized studies remain to prove whether the inhaled chemotherapy is an efficient and safe treatment modality.

PEGylation of paclitaxel largely improves its safety and anti-tumor efficacy following pulmonary delivery in a mouse model of lung carcinoma

“…Moreover, safety issue remains a major consideration for inhaled chemotherapeutics. The inhalation of cytotoxic drugs may cause transient high local drug concentrations, which may lead to toxicity to the lung tissue [7][8][9]. Therefore, the benefits and the challenges of inhaled chemotherapy have stimulated interests in the development of delivery systems for retaining and progressively releasing anti-cancer drugs in the lungs [10][11][12][13][14][15][16].…”

Inhaled Chemotherapy in Lung Cancer: Safety Concerns of Nanocomplexes Delivered

“…Since previous inhaled agents, therapies for systemic diseases have been approved and are already on the mar ket; other systemic therapies, such as inhaled chemo therapy in lung cancer, are under in vitro and in vivo evaluation [7]. A major concern regard ing this route of administration is the safety of chemotherapeutic agents for lung parenchyma.…”

“…The efficacy and safety of such approaches have been evaluated in vitro and in vivo for several chemo therapeutic drugs, either in their commer cial or nanocomplexed forms [7,[11][12][13][14][15][16][17][18]. The major advantages of inhaled chemotherapeutic agents include reduced systematic side effects and effi cient control of micrometastasis.…”

“…The adverse respiratory effect observed was an acute form of dosedependent pneumonitis, which, in some cases, induced pulmonary edema, alveolar hem orrhage and death in animals [13,21]. These adverse effects were recorded in very low numbers and were not observed in human patients, possibly as a result of the different structure and defense mechanisms of the human respiratory system [7,11,12]. Respiratory evaluation in patients has predominantly included respiratory function tests (e.g., forced expiratory volume in 1 s, forced vital capacity, diffusing capacity of the lung for CO and peak expiratory flow) and broncho alveolar lavage.…”

“…It was observed that inhaled cortico steroid administration and broncho dilators protected patients from symptoms, notably broncho spasm and cough. Nevertheless, in some cases, fever remained for a maximum of 3 days and was dose dependent [7,11]. Safety concerns regard ing the medical staff urged the investigators to perform the inhalation administration inside a highefficiency particulate air system and evalu ate whether any inhaled aerosol was not properly absorbed or administered [12].…”