Abstract
Global cancer prevalence has continuously increased in the last decades despite substantial progress achieved for patient care. Cancer is no longer recognized as a singular disease but as a plurality of different ones, leading to the important choice of the drug administration route and promoting the development of novel drug-delivery systems (DDS). Due to their structural diversity, therapeutic cancer drugs present specific challenges in physicochemical properties that can adversely affect their efficacy and toxicity profile. These challenges are addressed by innovative DDS to improve bioavailability, pharmacokinetics and biodistribution profiles. Here, we define the drug delivery challenges related to oral, intravenous, subcutaneous or alternative routes of administration, and review innovative DDS, marketed or in development, that answer those challenges.
Highlights
Oral route is the patients’ preferred mode of delivery due to simplicity and noninvasiveness. This route faces two major challenges: the low bioavailability of the drug substance and the targeted delivery to a defined section of the GI tract
Oral route is commonly used in multiple cancer indications and is perfectly appropriate for gastrointestinal cancers
Intravenous administration is the most commonly route for cancer drugs, ensuring high bioavailability and low inter-/intra-patient variability. This delivery route faces numerous challenges such as: non-favorable pharmacokinetics parameters of the drug substance, nonspecificity of some chemotherapeutic agents leading to severe side effects and difficulty to overcome highly protective barriers
Summary
First draft submitted: 25 June 2020; Accepted for publication: 27 November 2020; Published online: 14 December 2020. Cancer remains the second leading cause of death after cardiovascular diseases, with 9.6 million victims worldwide in 2018, and cancer deaths are projected to increase by 60% in the two decades [1]. The pharmaceutical industry has been increasingly focusing its efforts on the research, development and marketing of new oncology drug products to fulfill unmet medical need, leading to the approval of 90 new cancer drugs by the US FDA since 2012 [2]. Among those new drugs, more than 30% are dedicated to the treatment of blood and lymph node
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