Nanomedicine in Cancer Treatment: Efficacy and Toxicity Profile of PEGylated Liposomal Doxorubicin Compared to Conventional Doxorubicin: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Abstract

BackgroundCancer [CA] has a major impact on society in the United States (U.S.) and worldwide. as one of the leading causes of morbidity and mortality in all continents, accounting for 8.8 million deaths in 2015. As indicated by the World Health Organization (WHO), there will be 15 million new cases of CA worldwide in 2020. In developed countries, CA represents the second leading cause of death, exceeded only by heart disease. Current interventions for CA incorporate a combination of radiation, chemotherapy and surgery. Conventional CA drugs display distinctive toxicity and adverse effects compared to nanoformulated CA drugs (nanomedicines). Nanotechnology offers an enhanced technique for delivering anti‐CA drugs at molecular level in neoplasms while avoiding any harm to the normal rapidly proliferating cells in the body.AimTo facilitate the benefits, efficacy and safety assessment of nanomedicines, this research aimed to gain insight into the effects specific for the nanomedicine PEGylated Liposomal Doxorubicin (PLD) by systematically reviewing and analyzing the available data utilizing published research articles discussing randomized controlled trials [RCT] PLD to conventional CA drugs or treatments. In addition, by comparing Doxorubicin, the same active pharmaceutical ingredient in a conventional formulation versus a nanoformulation, this research aimed to identify any adverse effects specific for the nano aspect PLD.MethodsA systematic review and analysis of research articles published on nanotechnology and nanomedicine in CA treatment and therapy was performed utilizing different online databases and indexes available. This research focused on identifying research articles discussing nanomedicine in CA treatment with special emphasis on RCT comparing PEGylated Liposomal Doxorubicin(PLD) to conventional CA drugs. Restrictive exclusion and inclusion criteria were defined leading to a selection of relevant articles that used comparable experimentaldesigns. Critical appraisal of those studies was performed and the results were summarized in a table of evidence.ResultsThe objective was to investigate whether particular toxicity could be related to PLD and whether a nanoformulation of an active pharmaceutical ingredient altered the nature of adverse effects of the product in humans compared to a conventional formulation. The study of toxicity information did not reveal nanospecific toxicity that could be related to PLD.ConclusionCompared to conventional CA therapies, nanomedicine have the following advantages: it may increase the bioavailability of poorly soluble drugs, may prolongs drug circulation times in vivo, and permits multiple drug loading, all of which could improve drug efficacy and reduce toxicity. Furthermore, nanomedicine can maintain the synergistic ratio of the drugs; deliver the drugs to the tumor at the same time, such that two or more drugs of tumor treatment achieve synchronization in time and space; and alter the pharmacokinetics and distribution profile in vivo such that these are dependent on nanocarrier properties (rather than being dependent on the drugs themselves). This research has demonstrated that PEGylated Liposomal Doxorubicin (PLD) is highly effective and associated with a significantly lower risk of toxicity and an improved therapeutic index [TI] compared to conventional doxorubicin without any compromise in efficacy, and makes it a favorable choice over conventional anthracyclines,Support or Funding InformationSupported by Institutional Resources of USAT Montserrat and the Einstein Medical Instiute, N. Palm Beach, FL. USAThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.