Diabetes and Obesity Drug Discovery & Therapy (Track)

Aerosols as a Novel Approach for Targeted Therapy of Pulmonary Neoplasm

Koshkina, Nadezhda V
Assistant Professor Div. Surgical Oncology MD Anderson Cancer Center 1515 Holcombe Blvd., Houston, TX 77030 USA

Abstract:

Despite wide application of aerosols for the treatment of respiratory diseases, this technology is not developed for the treatment of lung malignancies. Currently, most anticancer agents are delivered intravenously, that requires frequent visits to the hospital and adds to the expenses of treatment. Thus, there is room for medical, economic, and social improvement in delivery of care for cancer patients with lung malignancies and aerosols can be used for that. In addition to that aerosol offers a unique approach to treat lung malignancies - it allows to deliver drugs to cancer cells that grow on the periphery of the tumor. These cells are the most aggressive because their growth is not restricted by space, hypoxia and is not dependent on angiogenesis. In our preclinical studies with different anticancer agents, including camptothecin, taxol, gemcitabine, entinostat, etc., the effective therapeutic doses of aerosolized drugs for the treatment of lung metastases were significantly lower than intravenous doses. In few cases inhalation dose was 100-200 fold lower than therapeutically effective systemic dose. This indicates that therapeutic concentration of drugs in the lungs can be achieved with much lower systemic exposure by using aerosol delivery.  In many cases the therapeutic effect was not limited to the lung site, but affected the growth of tumors at other locations. We designed an in-home aerosol unit that allows patients to get treatments at home, which we currently use in our clinical trials. Recent clinical trials demonstrated that inhalation of anticancer compounds was well-tolerated and needs further investigation. We anticipate that combination of aerosol delivery with systemic drug administration will allow to maximize the therapeutic “attack” on the lung malignancies.