The cremaphor formulation of paclitaxel has dose limiting toxicity which prevent its use for pancreatic cancer. Paclitaxel’s toxicity like the majority of chemotherapeutics stems from its systemic delivery and toxicity to normal cells. However recently an albumin-bound formulation (nab-paclitaxel) has demonstrated increased survival times in combination with gemcitabine compared to gemcitabine alone . And now a new biodegradable device has been developed which can deliver chemotherapeutics including paclitaxel directly to the pancreas limiting systemic toxicities .
The device has been tested with paclitaxel and shown favourable results in mouse xenograft models over systemically delivered paclitaxel. The device is flexible and can be surgically placed over the pancreatic tumour where it rests delivering a steady flow of paclitaxel for the duration of the treatment. The one time insertion is an attractive aspect compared with repeated intravenous deliveries.
Improving delivery and dosing of existing pancreatic cancer chemotherapeutics is a growing area of commercial research. Devices under development include an implantable electroporation device (see here) and encapsulated 293 cells that activate prodrug-chemotherapeutics (see here). Another approach uses low dose chemotherapy to take advantage of pancreatic cancer heterogeneity to maintain stable disease (see here).
- Ma, W. W., and M. Hidalgo. ‘The Winning Formulation: The Development of Paclitaxel in Pancreatic Cancer’. Clinical Cancer Research 19, no. 20 (15 October 2013): 5572–79. doi:10.1158/1078-0432.CCR-13-1356.
- Ligorio, Matteo, Laura Indolfi, David T. Ting, Kristina Xega, Nicola Aceto, Francesca Bersani, Cristina R. Ferrone, et al. ‘Abstract 4584: A Novel Drug-Eluting Platform for Localized Treatment of Pancreatic Cancer’. Cancer Research 74, no. 19 Supplement (10 January 2014): 4584–4584. doi:10.1158/1538-7445.AM2014-4584.