Strategies to improve drug delivery in bladder cancer therapy

Abstract

Bladder cancer is the ninth most common malignancy in the world featuring very high gender variability in occurrence. Current options for bladder cancer therapy include surgery, immunotherapy, chemotherapy and radiotherapy with a trend towards multimodal treatments. However, successful management remains a challenge for urologists and oncologists because of the high risk for recurrence and progression. Particularly in the field of bladder cancer chemotherapy, efficacy of treatment might be improved by advanced drug delivery strategies aimed at prolonged residence time within the bladder cavity and increased permeability of the bladder wall during intravesical instillation. Moreover, a deeper understanding of the biology of bladder carcinogenesis and malignant progression stimulated the development of a new generation of anticancer drugs for targeted therapies that might result in increased treatment specificity together with lower toxic potential and higher therapeutic indices. This review discusses the available strategies for ‘targeted therapy’, focusing on molecular targets, and for ‘controlled delivery’, comprising all other approaches towards improved drug delivery.

Keywords::

• bladder cancer
• chemotherapy
• controlled delivery
• drug targeting
• intravesical delivery
• targeted therapy
• urothelial cell carcinoma

Acknowledgements

The authors would like to thank L Neutsch for critically reading the manuscript.

M Wirth and VE Plattner contributed equally to this work.

Declaration of interests

The authors state no conflict of interest and have received no payment in the preparation of this manuscript.

Notes