Exploring Drug Delivery to the Peritoneum

The Peritoneal cavity (PC) isthekey metastatic site for intra-abdominal malignancies (e.g.,GI tract and rectal cancer). PCsitescan be used to target several other diseases where lymphatic drug delivery is desired without dumping largeamountsofthedrug. Till recently, it was thought that treatment with curative intent was impossible but that was challenged by the introduction of cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC),and PIPAC (pressurized intraperitoneal aerosol chemotherapy). Recently, a growing number of preclinical and clinical studies advocate intraperitoneal (IP) chemotherapy as an alternative post-operative therapyforcancer. Although their effectiveness has been proven both experimentally and clinically, there is still little understandingoftherole of drug delivery systems (DDS)intargeting drugsinthe intraperitoneal (IP)cavity. There are two main challenges one posed by IP cavity where the residence time of a small molecular weight drug (<20 kDa) is not sufficiently long to maintain therapeutic effect. This leads to frequent or continuous dosing. Another challenge isdevice-related orcatheter-related problems, such as catheter obstruction, increased risk of infection, and bowel complications. Overall literature shows thattheIP site issatisfactorilyexplored bycliniciansbut in terms of drug delivery not that much. One can seea clear-cutgap of expertise exchange betweenthetwo fields and guidelines fromregulatorylawmakerson new medications. In summary, challenges like delivery to IP cavity, tumor ororgan-specifictargeting, efficient tissue penetration, optimal cellular uptake and intracellular residence of a drug, biocompatibility, toxicity,etc can be easily solved by smartly designing functional drug delivery systems (both nano and micro). Nanotechnologies have always fascinatedhumansforseveral decades and are now widely explored inthebiomedical field. Diverse types of nanoparticles are being explored around the world, some examples include biodegradable nanoparticles, green nanoparticles, polymeric nanoparticles, lipid nanoparticles, metal nanoparticles, graphene, carbon nanotubes,and several others. Now a day's nanoparticles are gaining interest for drug targeting of chemotherapeutic drugs, immunotherapy,and gene delivery. Whereas microparticles can be explored for delayed drug delivery totheperitoneal cavity due to relativelyslowremoval from IP fluid. Hydrogels or other adhesive drug delivery may help to enhance peritoneal adhesions; thereby maintaining the balance betweenbenefit and risk. Overall, drug delivery systems are key in IP targeting. That means drug delivery specialist and clinician needs to be connected to getthebest out of this route of drug administration. The presentbook is a link between pharmaceuticalscientists(drugformulators), clinicians,toxicologists,and regulatory experts. This book also providesanew perspective to researchers to divert or guide their research inanoptimal way. Exploring Drug Delivery to the Peritoneum serves as a platform for upcoming technologies especially inthemedical devices sector to face up and show potential in deliveringdrugs. It is a chance for commercial partners like insurance companies andthepharma industry to explore this direction.