Targeted chemotherapy for head/neck cancer less toxic

Researchers at the University of Glasgow, Scotland, are working on a method to treat head and neck cancer (HNC) patients that delivers chemotherapy drugs via an intra-arterial system that is less toxic and has fewer side-effects.

Surgery and radiotherapy are the principal treatment options for HNC, along with chemotherapy, although the drugs are not recommended as a sole treatment due to their toxicity and low probability of cure, according to a university press release.

Chemotherapy usually is combined with radiotherapy and is administered intravenously, but the chemotherapy drugs are spread throughout a patient's body.

The school's researchers worked with Duncan Campbell, an oral and maxillofacial surgeon at St. John's Hospital, NHS Lothian in Scotland, to develop a new way of using intra-arterial delivery to concentrate chemotherapy drugs in the area around the tumor with lower doses for organs that are vulnerable to toxicity.

Chemotherapy is ideally given at high doses but results in significant toxicity, and the neutropaenia/immunosuppression resulting from chemotherapy risks fatal pneumonia, renal failure, and other morbidities, Dr. Campbell noted.

Intra-arterial methods could map and control the dose gradients in different parts of the body, he said.

Studies show less toxicity using the intra-arterial route but the technique hasn't been used because the pharmacodynamics, flow gradients, and individual variation between cancers and patients is not well understood, Dr. Campbell said.

He and his colleagues are studying blood flow in the tumor area, which is an important step in customizing the treatment to give each cancer the biggest chemo dose while reducing the toxicity for the vulnerable organs that need to remain healthy.

By taking into account parameters, such as the location of injection, the pressure applied in injecting the fluid, the speed of blood flow, and pulse rate, the researchers can find the right way to inject the therapeutic agent that will concentrate it at the desired location.

The new treatment method could have a significant impact on HNC cure rates, early detection, and quality of life for patients who cannot be cured by conventional means, and it could be useful to cure other cancers.

Clinical trials are not expected to begin for at least a year.

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