Hyperthermia can alter tumor physiology and improve chemo- and radio-therapy efficacy

Adv Drug Deliv Rev. 2020:163-164:98-124. doi: 10.1016/j.addr.2020.07.007. Epub 2020 Jul 15.

Abstract

Hyperthermia has demonstrated clinical success in improving the efficacy of both chemo- and radio-therapy in solid tumors. Pre-clinical and clinical research studies have demonstrated that targeted hyperthermia can increase tumor blood flow and increase the perfused fraction of the tumor in a temperature and time dependent manner. Changes in tumor blood circulation can produce significant physiological changes including enhanced vascular permeability, increased oxygenation, decreased interstitial fluid pressure, and reestablishment of normal physiological pH conditions. These alterations in tumor physiology can positively impact both small molecule and nanomedicine chemotherapy accumulation and distribution within the tumor, as well as the fraction of the tumor susceptible to radiation therapy. Hyperthermia can trigger drug release from thermosensitive formulations and further improve the accumulation, distribution, and efficacy of chemotherapy.

Keywords: Blood flow; Chemotherapy; Hyperthermia; Hypoxia; Interstitial fluid pressure; Radiotherapy; Thermosensitive liposome; Tumor pH; Vascular permeability.

Publication types

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

MeSH terms

  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use
  • Capillary Permeability / physiology
  • Combined Modality Therapy
  • Drug Delivery Systems / methods
  • Drug Liberation
  • Humans
  • Hydrogen-Ion Concentration
  • Hyperthermia / physiopathology*
  • Hyperthermia, Induced / methods*
  • Neoplasms / blood supply
  • Neoplasms / physiopathology
  • Neoplasms / therapy*
  • Oxygen / blood
  • Radiotherapy / methods*
  • Time Factors
  • Tumor Microenvironment / physiology

Substances

  • Antineoplastic Agents
  • Oxygen

Grants and funding