Targeting tumor stroma and exploiting mature tumor vasculature to improve anti-cancer drug delivery

Drug Resist Updat. 2007 Jun;10(3):109-20. doi: 10.1016/j.drup.2007.03.001. Epub 2007 Apr 23.

Abstract

The identification of a critical role of tumour stroma in the regulation of tumour interstitial fluid pressure and the simultaneous discovery of the impact of anti-angiogenic drugs on tumour hemodynamics have provided new potential for improving tumour delivery of anti-cancer drugs. Here, we review the most recent studies investigating how tumour-associated fibroblasts and macrophages as well as the extracellular matrix itself may be targeted to facilitate delivery of both low-molecular weight drugs and macromolecules. In addition, we summarize the current understanding of the use of vasoactive compounds, radiotherapy and vascular-disrupting agents as potential adjuvants to maximize tumour delivery of anti-cancer drugs. The impact of these strategies on the diffusive and convective modes of drug transport is discussed in the light of Fick's and Starling's laws. Finally, we discuss how transcytosis through caveolae may also be exploited to optimize the selective delivery of conventional chemotherapy to the subendothelial tumour cell compartment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiogenesis Inhibitors / pharmacology*
  • Antineoplastic Agents / pharmacology*
  • Biological Transport
  • Combined Modality Therapy
  • Drug Delivery Systems*
  • Fibroblasts / drug effects
  • Fibroblasts / pathology
  • Humans
  • Macrophages / drug effects
  • Macrophages / pathology
  • Neoplasms / drug therapy*
  • Neoplasms / physiopathology
  • Neoplasms / radiotherapy
  • Neovascularization, Pathologic / drug therapy
  • Stromal Cells / drug effects
  • Stromal Cells / pathology

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents