Rosière R, Hureaux J, Levet V, Amighi K, Wauthoz N
Laboratoire de pharmacie galénique et de biopharmacie, faculté de pharmacie, université libre de Bruxelles, boulevard du Triomphe, campus plaine CP207, 1050 Bruxelles, Belgique.
Service de pneumologie, unité micro et nanomédecines biomimétiques (MINT), université d'Angers, Inserm 1066, CNRS 6021, université Bretagne-Loire, centre hospitalier universitaire, pôle Hippocrate, 49033 Angers, France.
Rev Mal Respir. 2018 Apr;35(4):378-389. doi: 10.1016/j.rmr.2018.02.002. Epub 2018 May 3.
Lung tumours have a high incidence and cause many deaths worldwide. Despite progresses in treatment with targeted therapies and immunotherapies, the global 5-year survival rate remains low. In this context, inhaled chemotherapy could provide a means to intensify current therapeutic modalities. This review is based on clinical studies of inhaled chemotherapy against lung tumours. The advantages of this approach in terms of pharmacokinetic ratio and therapeutic index are presented as well as the limitations including contraindications and pulmonary side effects. Moreover, the challenges linked to technical aspects around administration are identified (inhalation device and facilities to limit aerosol propagation and exposure of healthcare professionals). The current developments proposed to overcome these challenges are described briefly. Also discussed are the potential applications for the distribution of the inhaled anticancer drug into tumour-bearing respiratory tracts and finally the potential indications for current therapeutic modalities.
肺癌在全球范围内发病率高,导致众多死亡。尽管靶向治疗和免疫治疗取得了进展,但全球5年生存率仍然很低。在这种背景下,吸入化疗可为强化当前治疗方式提供一种手段。本综述基于针对肺癌的吸入化疗临床研究。阐述了这种方法在药代动力学比率和治疗指数方面的优势以及包括禁忌症和肺部副作用在内的局限性。此外,还确定了与给药技术方面相关的挑战(吸入装置以及限制气雾剂传播和医护人员暴露的设施)。简要描述了为克服这些挑战而提出的当前进展。还讨论了吸入抗癌药物在荷瘤呼吸道分布的潜在应用,以及当前治疗方式的潜在适应症。