Freeman A I, Mayhew E
Cancer. 1986 Jul 15;58(2 Suppl):573-83. doi: 10.1002/1097-0142(19860715)58:2+<573::aid-cncr2820581328>3.0.co;2-c.
Cancer chemotherapy drugs are neither specific, i.e., they do not act exclusively on the metabolic pathways of cancer cells, nor are they targeted solely toward cancer cells. However, recent research has begun to address, in part, the latter issue. Improved delivery of chemotherapeutic agents to tumor tissue in man appears to be an achievable goal in the next decade. Improved drug delivery includes developing predictive models that allow for laboratory assessment of the best treatment for a patient's cancer without exposing the patient to an empirical trial or to the possible morbidity from exposure to a less useful drug, or to the loss of time in the fight against cancer because of ineffectual therapy. Monoclonal antibodies directed against tumor-associated antigens have the potential to achieve major advances in targeted drug delivery. Monoclonal antibodies may have direct antitumor effects, or they can be used as "homing devices" when attached to a payload and can guide diagnostic or therapeutic agents to the targeted tissues. Carrier systems of all types have become available; these include liposomes and polymeric compounds which can carry drugs, radionuclides, toxins, or other materials in a protected environment. These carriers can also be bound to monoclonal antibodies for possible targeted delivery. Pharmacological sanctuaries have been recognized as a problem in cancer treatment. The best known of these is the central nervous system (CNS). Techniques to temporarily disrupt the blood-brain barrier are now appearing. Mechanisms to administer therapy directly into the CNS are also being reassessed. Implantable pumps and reservoirs have been used to treat selected organs or for regional perfusions. Other treatments that are regional in scope include administration directly into a cavity or into a tumor. Computerized implantable devices should play a major role in cancer therapy in the future, in pain control as well as antibiotic and hormone administration. In recent years, mathematical models have been developed that can more accurately predict drug distribution and metabolism in various tissues of the body. Such models point the way to more logical designs of chemotherapeutic administration. The expanded use of autologous bone marrow transplantation, along with improving techniques of "purging" the marrow of tumor cells before reinfusion can be anticipated. Pro-drugs are substances that must be biotransformed in vivo to exert their pharmacologic effect.(ABSTRACT TRUNCATED AT 400 WORDS)
癌症化疗药物既不具有特异性，即它们并非仅作用于癌细胞的代谢途径，也并非仅靶向癌细胞。然而，近期的研究已开始部分解决后一个问题。在未来十年中，改善化疗药物向人体肿瘤组织的递送似乎是一个可以实现的目标。改善药物递送包括开发预测模型，该模型可在不使患者接受经验性试验、不使患者因接触疗效欠佳的药物而可能出现发病情况，或不因无效治疗而在抗癌斗争中浪费时间的情况下，通过实验室评估为患者的癌症确定最佳治疗方案。针对肿瘤相关抗原的单克隆抗体在靶向药物递送方面有可能取得重大进展。单克隆抗体可能具有直接抗肿瘤作用，或者当与有效载荷连接时可作为“归巢装置”，并能将诊断或治疗剂导向靶组织。各种类型的载体系统已经出现；这些包括脂质体和聚合物化合物，它们可以在受保护环境中携带药物、放射性核素、毒素或其他物质。这些载体也可以与单克隆抗体结合以实现可能的靶向递送。药理学庇护所已被认为是癌症治疗中的一个问题。其中最知名的是中枢神经系统（CNS）。暂时破坏血脑屏障的技术现在正在出现。将治疗直接施用于中枢神经系统的机制也在重新评估中。可植入泵和储液器已用于治疗特定器官或进行区域灌注。其他具有区域范围的治疗方法包括直接施用于体腔或肿瘤。计算机化可植入装置在未来的癌症治疗中，在疼痛控制以及抗生素和激素给药方面应发挥重要作用。近年来，已经开发出数学模型，能够更准确地预测药物在身体各个组织中的分布和代谢。此类模型为化疗给药的更合理设计指明了方向。可以预期自体骨髓移植的使用将扩大，同时在重新输注前清除骨髓中肿瘤细胞的技术也将得到改进。前体药物是必须在体内进行生物转化才能发挥其药理作用的物质。（摘要截选至400字）
