**The Airways: A Promising Route for the Pulmonary Delivery of Anticancer Agents**

Guilleminault L.1,2, Hervé-Grépinet V.1, Lemarié E.1,2 and Heuzé-Vourc'h N.1 *1INSERM U618, Université François Rabelais, Faculté de médecine, Tours 2Service de Pneumologie, CHRU Tours France* 

### **1. Introduction**

52 Advances in Cancer Therapy

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Castagnoli, P., Raposo, G. & Amigorena, S. (1998) Eradication of established murine tumors using a novel cell-free vaccine: dendritic cell-derived exosomes. *Nat Med*, 4, The outcome of lung cancer has not changed dramatically in recent years, despite the availability of new therapeutic agents. Lung cancer is the most common cause of cancerrelated death in all industrialised countries (28 % in the USA for 2009). It is usually treated by a combination of surgery, radiotherapy and chemotherapy; and anticancer drugs are generally given intravenously. But this delivery route leads to high drug concentrations in the systemic circulation, with some adverse side effects and low drug concentrations in the respiratory tract. Clearly, a new route for administering anti-cancer drugs is needed: the airways. Drugs for treating chronic respiratory diseases like asthma, chronic obstructive pulmonary disease (COPD) and cystic fibrosis are commonly delivered *via* the airways. The main advantage of this route is that the drug is delivered directly into the bronchi, bronchioles or deep lungs. Airway delivery should theoretically ensure longer exposure of the intended target to higher concentrations of the drug, while reducing adverse side effects. The patient should therefore benefit from a minimum drug concentration in the bloodstream and other body tissues. The airways therefore appear to be an attractive route for delivering anticancer agents in lung cancer, especially when other treatments have limited success, and in particular pathological situations, such as bronchioloalveolar carcinoma (BAC). This chapter provides an overview of the delivery of anticancer agents by aerosoltherapy for treating lung cancers and metastases, including the current status in the use of aerosoltherapy in oncology and future progress.
