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肿瘤学中的电动增强给药:原理、证据、当前及新兴应用

Electromotive Enhanced Drug Administration in Oncology: Principles, Evidence, Current and Emerging Applications.

作者信息

Min Jolene Wong Si, Saeed Nidda, Coene Annelies, Adriaens Mieke, Ceelen Wim

机构信息

Department of GI Surgery, Ghent University Hospital, 9000 Ghent, Belgium.

Department of Electromechanical, Systems and Metal Engineering, Faculty of Engineering and Architecture, Ghent University, 9000 Ghent, Belgium.

出版信息

Cancers (Basel). 2022 Oct 11;14(20):4980. doi: 10.3390/cancers14204980.

Abstract

Local-regional administration of cytotoxic drugs is an important adjunct to systemic chemotherapy amongst cancer patients. It allows for targeted delivery of agents at high concentration to target sites while minimizing systemic side effects. Despite the pharmacokinetic advantages of the local-regional approach, drug transport into tumor nodules remains limited due to the biophysical properties of these tissues. Electromotive enhanced drug administration (EMDA) represents a potential solution to overcome challenges in local drug transport by applying electric currents. Through electrokinetic phenomena of electromigration, electroosmosis and electroporation, electric currents have been shown to improve drug penetration and distribution in a wide variety of clinical applications. Amongst patients with non-muscular invasive bladder cancer (NMIBC) and basal and squamous cell skin cancers, EMDA has been successfully adopted and proven efficacious in several pre-clinical and clinical studies. Its application in ophthalmological and other conditions has also been explored. This review provides an overview of the underlying principles and factors that govern EMDA and discusses its application in cancer patients. We also discuss novel EMDA approaches in pre-clinical studies and explore future opportunities of developments in this field.

摘要

对癌症患者而言,细胞毒性药物的局部区域给药是全身化疗的重要辅助手段。它能将高浓度药物靶向递送至靶部位,同时将全身副作用降至最低。尽管局部区域给药方法具有药代动力学优势,但由于这些组织的生物物理特性,药物向肿瘤结节的转运仍然有限。电动增强给药(EMDA)通过施加电流,为克服局部药物转运中的挑战提供了一种潜在解决方案。通过电迁移、电渗和电穿孔等电动现象,电流已被证明能在多种临床应用中改善药物渗透和分布。在非肌肉浸润性膀胱癌(NMIBC)以及基底细胞癌和鳞状细胞皮肤癌患者中,EMDA已在多项临床前和临床研究中成功应用并被证明有效。其在眼科及其他病症中的应用也已得到探索。本综述概述了支配EMDA的基本原理和因素,并讨论了其在癌症患者中的应用。我们还讨论了临床前研究中的新型EMDA方法,并探索该领域未来的发展机遇。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77dc/9599758/b40fbb15e999/cancers-14-04980-g001.jpg

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