Strategic consideration for effective chemotherapeutic transportation via transpapillary route in breast cancer

Co-delivery of lapatinib and 5-fluorouracil transfersomes using transpapillary iontophoresis for breast cancer therapy

Combination chemotherapy, involving the intervention of two or more anti-neoplastic agents has been the cornerstone in breast cancer treatment, owing to the applications it holds in contrast to the mono-therapy approach. This research predominantly focussed on proving the synergy between Lapatinib (LPT) and 5-Fluorouracil (5-FU) and further enhancing its localized permeation via transfersome-loaded delivery and iontophoresis to treat breast tumors. The IC50 values for LPT and 5-FU were found to be 19.38 µg/ml and 5.7 µg/ml respectively and their synergistic effect was proven by the Chou-Talalay assay using CompuSyn software. Furthermore, LPT and 5-FU were encapsulated within transfersomes and administered via the transpapillary route. The drug-loaded carriers were characterized for their particle size, polydispersity index, zeta potential, and entrapment efficiency. The ex vivo rat skin permeation studies indicated that when compared to LPT dispersion and 5-FU solution, drug-loaded transfersomes exhibited better permeability and their transpapillary permeation was enhanced on using iontophoresis. Moreover, both LPT and 5-FU transfersomes were found to be stable for 3 months when stored at a temperature of 5 ± 3 °C. The results indicated that this treatment strategy could be an effective approach in contrast to some of the conventional treatments employed to date.

Nanostructured lipid carriers loaded into in situ gels for breast cancer local treatment

In this study, nanostructured lipid carriers (NLC) were developed and employed to obtain in situ thermosensitive formulations for the ductal administration and prolonged retention of drugs as a new strategy for breast cancer local treatment. NLC size was influenced by the type and concentration of the oil phase, surfactants, and drug incorporation, ranging from 221.6 to 467.5 nm. The type of liquid lipid influenced paclitaxel and 5-fluorouracil cytotoxicity, with tributyrin-containing NLC reducing IC50 values by 2.0-7.0-fold compared to tricaprylin NLC in MCF-7, T-47D and MDA-MB-231 cells. In spheroids, the NLCs reduced IC50 compared to either drug solution (3.2-6.2-fold). Although a significant reduction (1.26 points, p < 0.001) on the health index of Galleria mellonella larvae was observed 5 days after NLC administration, survival was not significantly reduced. To produce thermosensitive gels, the NLCs were incorporated in a poloxamer (11 %, w/w) dispersion, which gained viscosity (2-fold) at 37 °C. After 24 h, ∼53 % of paclitaxel and 83 % of 5-fluorouracil were released from the NLC; incorporation in the poloxamer gel further prolonged release. Intraductal administration of NLC-loaded gel increased the permanence of hydrophilic (2.2-3.0-fold) and lipophilic (2.1-2.3-fold) fluorescent markers in the mammary tissue compared to the NLC (as dispersion) and the markers solutions. In conclusion, these results contribute to improving our understanding of nanocarrier design with increased cytotoxicity and prolonged retention for the intraductal route. Tributyrin incorporation increased the cytotoxicity of paclitaxel and 5-fluorouracil in monolayer and spheroids, while NLC incorporation in thermosensitive gels prolonged tissue retention of both hydrophilic and hydrophobic compounds.

A glutathione-responsive PEGylated nanogel with doxorubicin-conjugation for cancer therapy

The complexity, degradability, and stability of drug delivery systems are crucial factors for clinical application. Herein, a glutathione (GSH)-responsive polyethylene glycol (PEG)ylated nanogel conjugated with doxorubicin (Dox) was prepared based on a linker with disulfide bonds, PEG, and Dox using a one-pot method. FT-IR and UV-vis analyses confirmed that all raw materials were incorporated in the Dox-conjugated nanogel structure. Dynamic light scattering (DLS) and transmission electron microscopy (TEM) results showed that the particle size of the Dox-conjugated nanogel was at the nanoscale and could be responsively disrupted in high GSH concentration. The in vitro accumulative Dox release rate from the nanogel reached 88% in PBS with 5 mg mL-1 GSH on day 4. Moreover, H22 cell viability and apoptosis experiments revealed that the nanogel effectively inhibited tumor cell growth. In vivo tracking and cell uptake experiments demonstrated that the nanogel accumulated and persisted in tumor tissues for 5 days and was distributed into cell nuclei at 6 h. Furthermore, H22-bearing mice experiments showed that the tumor size of the Dox-conjugated nanogel group was the smallest (287 mm3) compared to that of the free Dox (558 mm3) and 0.9% NaCl (2700 mm3) groups. Meanwhile, the body weight of mice as well as the H&E and TUNEL tissue section staining of organs and tumor tissues from the mice illustrated that the nanogel could significantly prevent side effects and induce tumor cell apoptosis. Taken together, compared with free Dox, the Dox-conjugated nanogel exhibited higher therapeutic efficacy and lower side effects in normal tissues, making it a potential novel nanomedicine for cancer.

Valorization of different low-grade date (Phoenix dactylifera L.) fruit varieties: A study on the bioactive properties of polyphenolic extracts and their stability upon in vitro simulated gastrointestinal digestion

Nowadays, the development of suitable strategies for the management and valorization of agri-food products is one of the most important challenges worldwide. In this context, the current research study aimed to explore a valorization strategy for different varieties (Khalas, Jabri, Lulu, Booman, and Sayer) of low-grade date fruit by extracting polyphenolic compounds and investigating their health-promoting bioactive properties. The generated extracts were comparatively analyzed for their phenolic contents, antioxidant, anti-inflammatory, anti-hemolytic, and enzyme inhibitory activities upon in vitro simulated gastrointestinal digestion (SGID). The total phenolic contents (TPC) ranged from 217.3 to 1846.9 mg GAE/100 g fresh weight. After complete SGID, the TPC remarkably increased from 570.8 mg GAE/100 g fresh weight (undigested), reaching the highest value of 1606.3 mg GAE/100 g fresh weight with the Khalas cultivar. Overall, gastric and complete-SGID-treated extracts exhibited higher antioxidant activities, compared to the undigested extracts for the five selected date varieties. Similarly, the gastric and complete SGID promoted the release of bioactive components endowed with significantly higher inhibition levels towards digestive enzymes related to diabetes. Moreover, extracts from all varieties revealed an increase in the inhibition of lipidemic-related enzymatic markers and anti-inflammatory activities when subjected to the gastric digestion phase, which decreased after complete SGID. Principal component analysis (PCA) suggested that higher bioactive properties were influenced by the TPC present in the samples. Overall, low-quality dates could be considered as a potential source of bioactive polyphenols with interesting nutraceutical properties, released upon their transit through the gastrointestinal tract.

Non-systemic Approaches for Ductal Carcinoma In Situ: Exploring the Potential of Ultra-flexible Combisomes as a Novel Drug Delivery Strategy-a Review

Ductal carcinoma in situ (DCIS) is currently treated through breast-conserving surgery (lumpectomy), radiation therapy, breast-removing surgery (mastectomy), and hormone therapy to prevent further progression into invasive breast cancer and recurrence. Discrepancies concerning the prognosis of DCIS have sparked controversy about adequate treatment. Considering the severe medical and psychological consequences of mastectomy, developing a treatment approach that arrests the progression of DCIS to the invasive stage without affecting the non-cancerous cells is of utmost importance. In the current review, the problems associated with the diagnosis and management of DCIS have been thoroughly discussed. A summary of the route of administration and drug delivery systems to manage DCIS was also provoked. Innovative ultra-flexible combisomes were also proposed for the effective management of DCIS. Prevention is essential in managing the risk of DCIS and reducing the risk of progression to invasive breast cancer. While prevention is vital, it is not always possible to prevent DCIS, and in some cases, treatment may be necessary. Hence, this review recommends that ultra-flexible combisomes administered as a topical gel provide a non-systemic approach for managing DCIS and thus significantly minimize the side effects and costs associated with existing therapies.

Transdermal delivery via medical device technologies

INTRODUCTION

Despite their effectiveness and indispensability, many drugs are poorly solvated in aqueous solutions. Over recent decades, the need for targeted drug delivery has led to the development of pharmaceutical formulations with enhanced lipid solubility to improve their delivery properties. Therefore, a dependable approach for administering lipid-soluble drugs needs to be developed.

AREAS COVERED

The advent of 3D printing or additive manufacturing (AM) has revolutionized the development of medical devices, which can effectively enable the delivery of lipophilic drugs to the targeted tissues. This review focuses on the use of microneedles and iontophoresis for transdermal drug delivery. Microneedle arrays, inkjet printing, and fused deposition modeling have emerged as valuable approaches for delivering several classes of drugs. In addition, iontophoresis has been successfully employed for the effective delivery of macromolecular drugs.

EXPERT OPINION

Microneedle arrays, inkjet printing, and fused deposition are potentially useful for many drug delivery applications; however, the clinical and commercial adoption rates of these technologies are relatively low. Additional efforts is needed to enable the pharmaceutical community to fully realize the benefits of these technologies.

Transpapillary iontophoretic delivery of resveratrol loaded transfersomes for localized delivery to breast cancer

Localized drug delivery to the breast tissues is an area of interest as a potential route to ensure site-specific drug delivery. Transpapillary delivery via the mammary papilla has advantages as most breast tumors arise from the milk ducts. The present study explored the plausibility of transpapillary delivery of a phytochemical, resveratrol (RVT), for breast cancer treatment. RVT was encapsulated within the transfersomes (RVT-TRF) to enable a sustained release of the drug using the biomaterial soya phosphatidylcholine (SPC). Iontophoresis was applied to further accelerate the penetration of the RVT-TRF across the mammary papilla to the breast tissue. The RVT-TRF development was optimized by the Design of Experiments (DoE) approach. The in vitro transpapillary iontophoresis study on porcine mammary papilla showed an enhanced penetration of RVT-TRF when compared to passive diffusion. The transpapillary delivery was further confirmed from the in vitro fluorescent microscopy study using FITC conjugated RVT-TRF. The optimized RVT-TRF delivered via transpapillary route showed a higher C_max and AUC when compared to pure RVT given orally. A significant reduction in the tumor volume and the serum biomarker CA 15-3, when evaluated in a chemically induced breast cancer rat model, provided evidence of the effectiveness of the developed formulation when delivered locally via transpapillary route compared to the oral route. Thus the developed RVT-TRF administered via transpapillary iontophoresis technique is a promising strategy enabling a localized delivery for effective breast cancer therapy.

Therapeutische Besonderheiten bei Erkrankungen der Mamillenhaut

Die Mamillenregion ist durch besondere anatomische Verhältnisse charakterisiert und lässt sich aus dermatologischer Perspektive in Brusthaut, Haut des Brustwarzenhofes (Areola) und Haut der Brustwarze (Papilla mammae) unterteilen. Im klinischen Zusammenhang sind die Brustwarzen häufig während der Stillzeit durch mechanische Beanspruchung, Milieuänderung mit Mazeration durch den Milchfluss sowie durch mikrobielle Erreger alteriert. Zudem besteht hier die Gefahr der Entwicklung einer Mastitis puerperalis. Außerhalb der Schwangerschaft und Stillzeit finden sich gelegentlich an der Mamillenhaut Ekzemerkrankungen, häufig bei atopischer Disposition (atopisches Mamillenekzem) oder als irritatives Kontaktekzem („joggers nipple“). Seltener werden allergische Kontaktekzeme auf Konservierungsstoffe von Topika oder Metallen (Piercings) beobachtet. Auch im Rahmen einer Skabiesinfestation wird eine Beteiligung der Mamillen, insbesondere bei Frauen, regelmäßig beobachtet. Von großer klinischer Bedeutung sind seltene, präinvasive Läsionen eines Mammakarzinoms oder der Morbus Paget der Mamille vom extramammären Typ. Durch die besonderen anatomischen Gegebenheiten ist es naheliegend, dass bei der Anwendung von Topika sich auch spezifische Penetrationsbedingungen ableiten. Experimentelle Untersuchungen an Humanhaut ex vivo legen nahe, dass in Abhängigkeit von der Molmasse und der Löslichkeit des Arzneistoffs sowie des eingesetzten Vehikelsystems eine deutliche Zunahme der kutanen Bioverfügbarkeit, insbesondere an der Brustwarze selbst durch den transpapillären Diffusionsweg, auftreten kann. Dies sollte insbesondere bei der topischen Anwendung von Arzneistoffen mit bekanntem dosisabhängigem Nebenwirkungspotenzial (z. B. Glukokortikoiden) beachtet werden. Allerdings fehlt dafür bisher eine klinische Evidenz.

Folic acid anchored urchin-like raloxifene nanoparticles for receptor targeting in breast cancer: Synthesis, optimisation and in vitro biological evaluation

In this study, raloxifene hydrochloride (RLX) was loaded into bovine serum albumin nanoparticles (RLX-BSA-NPs) and further surface modified with folic acid (FA-RLX-BSA-NPs) for targeted breast cancer therapy. In statistical optimization of RLX-BSA-NPs, albumin and crosslinker concentration significantly affected particle size and entrapment efficiency of RLX-BSA-NPs. Structural characterizations confirmed that the formation of FA-RLX-BSA-NPs and SEM microphotographs resembled the urchin-like spiky feature. A sustained in vitro release pattern was observed till 120 h from FA-RLX-BSA-NPs in phosphate buffer. The MTT assay revealed maximum cell inhibition by FA-RLX-BSA-NPs against MCF-7 cells and MDA MB-231 cells at lower IC₅₀ values (0.5 µg/ml and 0.7 µg/ml) compared to RLX and RLX-BSA-NPs. The cell cycle analysis revealed that FA-RLX-BSA-NPs induced apoptosis of MCF-7 cells in the sub-G1 phase via folate receptor-α mediated endocytic uptake. Hence, the raloxifene nanoparticles stance as a potential nanocarrier for targeted therapy in breast cancer.

Targeted delivery of albumin nanoparticles for breast cancer: A review

Breast cancer has been identified as one of the most common cancers diagnosed in women. Various nanotechnology platforms offering unique features are considered in breast cancer treatment. Albumin is a versatile biodegradable, biocompatible, non-toxic and non-immunogenic protein nanocarrier. These characteristics attracted strong attention to fabricate albumin nanoparticles to deliver chemotherapeutic agents without major adverse effects. Albumin nanoparticles can undergo surface modifications using different ligands promoting tumor-targeted drug delivery. Moreover, multifunctional albumin nanoparticle is an upcoming strategy to attain efficient cancer therapy. This review gives an account of the potential albumin nanoparticles developed for chemotherapeutic drug delivery and its targeted approach for breast cancer. It also covers different multifunctional therapies available using albumin nanoparticles as breast cancer theranostics.

3D Printed Personalized Medicine for Cancer: Applications for Betterment of Diagnosis, Prognosis and Treatment

Cancer treatment is challenging due to the tumour heterogeneity that makes personalized medicine a suitable technique for providing better cancer treatment. Personalized medicine analyses patient-related factors like genetic make-up and lifestyle and designs treatments that offer the benefits of reduced side effects and efficient drug delivery. Personalized medicine aims to provide a holistic way for prevention, diagnosis and treatment. The customization desired in personalized medicine is produced accurately by 3D printing which is an established technique known for its precision. Different 3D printing techniques exhibit their capability in producing cancer-specific medications for breast, liver, thyroid and kidney tumours. Three-dimensional printing displays major influence on cancer modelling and studies using cancer models in treatment and diagnosis. Three-dimensional printed personalized tumour models like physical 3D models, bioprinted models and tumour-on-chip models demonstrate better in vitro and in vivo correlation in drug screening, cancer metastasis and prognosis studies. Three-dimensional printing helps in cancer modelling; moreover, it has also changed the facet of cancer treatment. Improved treatment via custom-made 3D printed devices, implants and dosage forms ensures the delivery of anticancer agents efficiently. This review covers recent applications of 3D printed personalized medicine in various cancer types and comments on the possible future directions like application of 4D printing and regularization of 3D printed personalized medicine in healthcare.

Microneedle system: a modulated approach for penetration enhancement

The microneedles show advantages over transdermal drug delivery systems on account of better skin permeation bypassing the stratum corneum. To increase the flux of permeation, penetration enhancement techniques like physical and chemical methods are combined with a trans-epidermal delivery system across the skin causing minimal pain. These techniques include iontophoresis, sonophoresis, and electroporation for physical enhancement of drug delivery via topical route by either disrupting the structure of the stratum corneum or by creating pores/micro-channels within the skin. The use of chemical penetrants such as ethanol, lipids, surfactants, and terpenes improves the release kinetics by mechanisms like fluidization of lipids, denaturation of proteins, etc. A combination of microneedles and these techniques show a significant increase in the permeability of drugs across the skin by 5-10 times compared to microneedles alone. This review article focuses on various advanced strategies like the use of drug-polymer complexes, application of ultrasound frequency or tolerable electric current, formation of nano-formulations, etc. with microneedle delivery for transportation of high payload of actives, macromolecules, antibodies, gene, proteins, and peptides. In the near future, microneedle systems will offer potential targeted drug delivery, self-sealable administration across the skin, and minimally invasive vaccine transportation in cancer, diabetes, Alzheimer's, and cardiovascular diseases.HighlightsPhysical penetration enhancement techniques: iontophoresis, electroporation, and sonophoresis.Chemical penetration enhancers: polymers, lipids, surfactants.Strategies to use microneedle system with penetration enhancement techniques.The significant difference in the penetration ability of high payload actives.

Recent advances in microneedles-based drug delivery device in the diagnosis and treatment of cancer

Microneedles are unique, novel and an effective approach designed to deliver therapeutic agents and immunobiologicals in several diseases. These tiny needle patches are designed to load vaccine, small or large drug molecule, heavy molecular weighted proteins, genes, antibodies, nanoparticles and many more. These nanoparticles loaded microneedles deliver drugs deep within the skin near underlying neutrophils, langerhans and dendritic cells and induces required immunological response. With the drawbacks associated with conventional methods of cancer chemotherapy, the focus was shifted towards use of microneedles in not just anti-cancer vaccine/drug delivery but also for their early diagnosis. This delivery device is also suited for synergistic approaches such as chemotherapy or gene therapy combined with photothermal or photodynamic therapy. The painless self-administrative device offers an alternative over traditional routes of drug delivery including systemic administration via hypodermic needles. Additionally, these microneedles can be fabricated and altered in shape, size and geometry and the material polymer can be chosen depending on use and release mechanism. This review consolidates positive results obtained from studies done for different type of microneedle array in several tumor cell lines and animal models. It further highlights the use of biodegradable polymers such as hydrogel or any dissolving polymer that can be utilized for sustained codelivery of drug/vaccine to shun the need of multiple dosing. It covers the existing limitations that still needs to be resolved and further highlights on the future aspects of their use in cancer therapy.

Exploring potential formulation strategies for chemoprevention of breast cancer: a localized delivery perspective

This review focuses on the various formulation approaches that have been explored to achieve localized delivery in breast cancer. The rationale behind the necessity of localized drug delivery has been extensively reviewed. The review also emphasizes the various possible routes for achieving localized drug delivery. Particularly, different types of nanoplatforms like lipid-based drug carriers, polymeric particles, hydrogels, drug conjugates and other formulation strategies like microneedles and drug-eluting implants, which have been used to increase tumor retention and subsequently halt tumor progression, have been deliberated here. In addition, the significant challenges that may be encountered in the delivery of anticancer drugs and the aspects that require careful evaluation for effective localized delivery of chemotherapeutic agents have been discussed.

Microneedles Drug Delivery Systems for Treatment of Cancer: A Recent Update

Microneedles (MNs) are tiny needle like structures used in drug delivery through layers of the skin. They are non-invasive and are associated with significantly less or no pain at the site of administration to the skin. MNs are excellent in delivering both small and large molecules to the subjects in need thereof. There exist several strategies for drug delivery using MNs, wherein each strategy has its pros and cons. Research in this domain lead to product development and commercialization for clinical use. Additionally, several MN-based products are undergoing clinical trials to evaluate its safety, efficacy, and tolerability. The present review begins by providing bird's-eye view about the general characteristics of MNs followed by providing recent updates in the treatment of cancer using MNs. Particularly, we provide an overview of various aspects namely: anti-cancerous MNs that work based on sensor technology, MNs for treatment of breast cancer, skin carcinoma, prostate cancer, and MNs fabricated by additive manufacturing or 3 dimensional printing for treatment of cancer. Further, the review also provides limitations, safety concerns, and latest updates about the clinical trials on MNs for the treatment of cancer. Furthermore, we also provide a regulatory overview from the "United States Food and Drug Administration" about MNs.

Potential of Chimeric Antigen Receptor T-Cells in Cancer Therapy

Novel approaches for targeted delivery like nanoparticles, liposomes, polymer conjugates, etc. with better safety profile needs to be developed for cancer treatment. Chimeric antigen receptors (CAR) with modified thymus cells (T-cells) showed greater potential as a therapy due to its direct effect on immune system responsible for destruction of pathogens and said equivalent to the living drug. On activation of T-cell, it binds to the antigen domains treating refractory or relapsed cancers. The receptors are termed chimeric as it consists of T-cells functioning as well as antigen-binding combined in sole receptor. This therapy showed positive success towards hematological cancers and engineered for specific protein targeting. Though the therapy is associated to several challenges like incompetence towards tumor lysis and cytokine release rate, termination of cytotoxic activity after completion of tumor eradication, etc. The control mechanisms used by CAR T-cells are apoptosis by suicide genes, dual-antigen receptor, ON-switch tumor attack and bispecific molecules as activation switch. In solid tumors, CAR T-cell therapy showed promising signs of efficacy becoming a game-changing cell therapy. CAR T-cells are optimized using different engineering resolutions and lead to broadways for therapy adoption to benefit the cancer patients.