Journal of Clinical Oncology, Vol 2, 498-504, Copyright © 1984 by American Society of Clinical Oncology
Pharmacologic rationale for regional drug delivery
JM Collins
Regional drug delivery is an approach designed to improve the selectivity
of chemotherapy. When compared with systemic drug administration, regional
delivery can potentially increase drug concentrations at tumor sites and/or
lower systemic drug exposure. Pharmacokinetic analysis can evaluate or even
predict the relative advantage of regional drug delivery. Based on a
quantitative analysis of regional drug delivery, some drugs and sites of
delivery are more favorable than others. The formulas for the therapeutic
advantage of intraarterial, intrathecal, and intraperitoneal delivery have
a similar structure. The ratio of total body clearance of a drug to its
regional exchange rate is the principal determinant of therapeutic
advantage. Thus, the most favorable circumstances for regional delivery are
the use of drugs with high total body clearances and/or sites of delivery
with low exchange rates. Pharmacodynamic factors must also be considered
for the overall assessment of regional delivery.
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