Development of inhalational agents for oncologic use

Because regional chemotherapy has been useful in treatment and palliation o f many cancer types, the concept of delivering drugs by inhalation for the treatment of cancers in the lung is attractive. Much higher local drug expo sure can be achieved with total doses considerably lower than those require d for systemic administration, resulting in lower exposure of nonrespirator y tract tissues to potentially toxic drugs. Regional delivery of chemothera py to the respiratory tract has been shown to have activity in preclinical and clinical studies. Technical improvements in delivery methods have now m ode it possible to conduct trials of inhalational agents, both to treat can cers affecting the respiratory tract and to deliver other drugs used in can cer patients. This review discusses the rationale of drug delivery by the i nhalational route, its technical challenges, preclinical and clinical exper iences, limitations, and promise. (C) 2001 by American Society of Clinical Oncology.