Chapter 7 - Novel targeting formulations in colorectal cancer

Abstract

Colorectal cancer (CRC) is the third most common cancer diagnosed worldwide in human beings. It is reported that over 40,000 adults alone in the United Kingdom are diagnosed with CRC each year. Significant developments in screening, prevention, biomarker and genomic analysis, nutritional supplement therapy, vaccination, and chemotherapy have improved detection with a reduction in mortality statistics. However, despite these advances, many patients with advanced and metastatic tumors still progress. Surgery, chemotherapy, radiotherapy, and targeted therapies are the four conventional approaches that are currently used for the treatment of CRC. Novel formulations incorporating active moiety to the site of action would increase effectiveness with reducing side effects. Moreover, targeted oral drug delivery systems based on pH-dependent polysaccharides are being formulated and investigated to deliver directly to the colon and rectum. Furthermore, site-specific drug delivery using various approaches, including in situ gelling film, nanosuspension, nanocomposite, nanogels, liposome, micelles, enteric-coated formulation, microencapsulation, microsphere, polymeric nanoparticles, cyclodextrin-based nanoparticles, solid lipid nanoparticles, metallic nanoparticles to colon increases its concentration at the target site and thus requires a lower dose and hence abridged side effects. Although several treatment options are available for CRC, the ultimate therapeutic approach is to avert the incidence of CRC. Several studies clearly reported that CRC could also be prevented by diet and nutrition such as calcium, vitamin D, polyphenols-rich herbs, and fish oil supplements. In addition, immunotherapy and vaccination are used in the management of CRC nowadays with promising results. In this chapter, a brief on various strategies in the management of CRC using various novel targeting formulations is discussed.