Department of Respiratory Medicine, Chun'an First People's Hospital, (Zhejiang Provincial People's Hospital Chun'an Branch), Hangzhou, PR China.
Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, PR China.
Drug Deliv. 2021 Dec;28(1):1995-2010. doi: 10.1080/10717544.2021.1981492.
Lung cancer is the second most common and lethal cancer in the world. Chemotherapy is the preferred treatment modality for lung cancer and prolongs patient survival by effective controlling of tumor growth. However, owing to the nonspecific delivery of anticancer drugs, systemic chemotherapy has limited clinical efficacy and significant systemic adverse effects. Inhalation routes, on the other hand, allow for direct delivery of drugs to the lungs in high local concentrations, enhancing their anti-tumor activity with minimum side effects. Preliminary research studies have shown that inhaled chemotherapy may be tolerated with manageable adverse effects such as bronchospasm and cough. Enhancing the anticancer drugs deposition in tumor cells and limiting their distribution to other healthy cells will therefore increase their clinical efficacy and decrease their local and systemic toxicities. Because of the controlled release and localization of tumors, nanoparticle formulations are a viable option for the delivery of chemotherapeutics to lung cancers via inhalation. The respiratory tract physiology and lung clearance mechanisms are the key barriers to the effective deposition and preservation of inhaled nanoparticle formulations in the lungs. Designing and creating smart nanoformulations to optimize lung deposition, minimize pulmonary clearance, and improve cancerous tissue targeting have been the subject of recent research studies. This review focuses on recent examples of work in this area, along with the opportunities and challenges for the pulmonary delivery of smart nanoformulations to treat lung cancers.
肺癌是世界上第二常见和最致命的癌症。化疗是肺癌的首选治疗方式，通过有效控制肿瘤生长来延长患者的生存时间。然而，由于抗癌药物的非特异性递送，全身化疗的临床疗效有限，且具有显著的全身不良反应。另一方面，吸入途径可以将药物直接递送到肺部，以高局部浓度给药，在最小副作用的情况下增强其抗肿瘤活性。初步研究表明，吸入化疗可能具有可耐受的不良反应，如支气管痉挛和咳嗽。因此，增加抗癌药物在肿瘤细胞中的沉积并限制其分布到其他健康细胞中，将提高其临床疗效并降低其局部和全身毒性。由于肿瘤的控制释放和定位，纳米颗粒制剂是通过吸入将化疗药物递送至肺癌的可行选择。呼吸道生理学和肺部清除机制是有效沉积和保留肺部吸入纳米颗粒制剂的关键障碍。设计和创建智能纳米制剂以优化肺部沉积、最小化肺部清除并提高癌症组织靶向性一直是最近研究的主题。本文重点介绍了该领域的最新工作实例，以及将智能纳米制剂用于治疗肺癌的肺部递药的机遇和挑战。
