Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA.
Interventional Medicine Innovation Group, Biocompatibles UK, Ltd. (Now Boston Scientific Corp.), Camberley, UK.
Expert Opin Drug Deliv. 2021 Mar;18(3):383-398. doi: 10.1080/17425247.2021.1835858. Epub 2021 Jan 22.
Drug-eluting embolic (DEE) microspheres, or drug-eluting beads (DEB), delivered by transarterial chemoembolization (TACE) serve as a therapeutic embolic to stop blood flow to tumors and a drug delivery vehicle. New combinations of drugs and DEE microspheres may exploit the potential synergy between mechanisms of drug activity and local tissue responses generated by TACE to enhance the efficacy of this mainstay therapy.
This review provides an overview of key drug delivery concepts related to DEE microspheres with a focus on recent technological developments and promising emerging clinical applications as well as speculation into the future.
TACE has been performed for nearly four decades by injecting chemotherapy drugs into the arterial supply of tumors while simultaneously cutting off their blood supply, trying to starve and kill cancer cells, with varying degrees of success. The practice has evolved over the decades but has yet to fulfill the promise of truly personalized therapies envisioned through rational selection of drugs and real-time multi-parametric image guidance to target tumor clonality or heterogeneity. Recent technologic and pharmacologic developments have opened the door for potentially groundbreaking advances in how TACE with DEE microspheres is performed with the goal of achieving advancements that benefit patients.
通过经动脉化疗栓塞术(TACE)输送的载药栓塞微球(DEE)或载药微球(DEB),既能作为治疗性栓塞剂阻止肿瘤血流,又能作为药物输送载体。新的药物与 DEE 微球组合可能利用 TACE 产生的药物作用机制与局部组织反应之间的潜在协同作用,增强这种主要治疗方法的疗效。
本综述概述了与 DEE 微球相关的关键药物输送概念,重点介绍了最近的技术发展和有前途的新兴临床应用,并对未来进行了推测。
近四十年来,TACE 通过向肿瘤的动脉供应中注射化疗药物,同时切断其血液供应,试图通过饥饿和杀死癌细胞来治疗肿瘤,取得了不同程度的成功。该实践在过去几十年中不断发展,但尚未实现通过合理选择药物和实时多参数图像引导来靶向肿瘤克隆性或异质性,从而实现真正个性化治疗的预期目标。最近的技术和药理学发展为如何通过载药栓塞微球进行 TACE 打开了潜在的突破性进展的大门,以期实现使患者受益的进展。